How much rates vary
Facilitymedian $1,622 · 10th to 90th $537 to $9,333Professionalmedian $447 · 10th to 90th $275 to $676
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 $281.84 Median $1,380.38 Typical High $7,762.47 | Facility | None | $281.84 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $478.63 | Professional | None | $281.84 | $363.08 | $478.63 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $1,949.84 Typical High $11,481.54 | Facility | None | $537.03 | $1,949.84 | $11,481.54 |
BCBS New Mexico Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $512.86 | Professional | None | $204.17 | $346.74 | $512.86 |
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 $309.03 Median $478.63 Typical High $676.08 | Professional | None | $309.03 | $478.63 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $346.74 Typical High $575.44 | Professional | None | $33.11 | $346.74 | $575.44 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $1,445.44 Typical High $2,089.30 | Facility | None | $275.42 | $1,445.44 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $676.08 | Professional | None | $331.13 | $489.78 | $676.08 |
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 $316.23 Median $478.63 Typical High $691.83 | Professional | None | $316.23 | $478.63 | $691.83 |
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 $141.25 Median $173.78 Typical High $239.88 | Professional | 52 · Reduced service | $141.25 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $95.50 | Professional | 53 · Discontinued | $56.23 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $263.03 Typical High $363.08 | Professional | 54 · Surgery only | $208.93 | $263.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $52.48 Typical High $72.44 | Professional | 55 · Aftercare only | $42.66 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $245.47 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $194.98 | $245.47 | $338.84 |
Where New Mexico sits
The same service costs 6.1 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 $6,346MT $1,043
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.