How much rates vary
Facilitymedian $1,622 · 10th to 90th $479 to $7,762Professionalmedian $275 · 10th to 90th $170 to $437
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $169.82 Median $1,380.38 Typical High $7,762.47 | Facility | None | $169.82 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $309.03 | Professional | None | $169.82 | $213.80 | $309.03 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $9,332.54 | Facility | None | $537.03 | $1,905.46 | $9,332.54 |
BCBS New Mexico Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $309.03 | Professional | None | $120.23 | $213.80 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,445.44 Typical High $1,995.26 | Facility | None | $776.25 | $1,445.44 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $436.52 | Professional | None | $199.53 | $295.12 | $436.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $223.87 Typical High $371.54 | Professional | None | $33.11 | $223.87 | $371.54 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $1,445.44 Typical High $2,089.30 | Facility | None | $223.87 | $1,445.44 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $436.52 | Professional | None | $204.17 | $295.12 | $436.52 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $426.58 | Professional | None | $190.55 | $288.40 | $426.58 |
6 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $104.71 Typical High $154.88 | Professional | 52 · Reduced service | $85.11 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $61.66 | Professional | 53 · Discontinued | $33.88 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $128.82 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $46.77 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.98 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $120.23 | $147.91 | $213.80 |
Where New Mexico sits
The same service costs 9.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $5,912MT $637
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.