How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $147.91 | Professional | None | $91.20 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $45.71 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $29.51 | Professional | 53 · Discontinued | $18.20 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $13.80 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $14.79 |
BCBS New Mexico Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $141.25 | Professional | None | $104.71 | $117.49 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $128.82 Typical High $134.90 | Facility | None | $125.89 | $128.82 | $134.90 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $181.97 | Facility | None | $154.88 | $154.88 | $181.97 |
United Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $100.00 | Professional | None | $61.66 | $66.07 | $100.00 |
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where New Mexico sits
The same service costs 2.4 times more in Montana than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Mexico· 18th of 51
$117
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.