How much rates vary
Facilitymedian $1,585 · 10th to 90th $646 to $7,413Professionalmedian $977 · 10th to 90th $646 to $1,380
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 $645.65 Median $1,548.82 Typical High $8,709.64 | Facility | None | $645.65 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $977.24 | Professional | None | $645.65 | $812.83 | $977.24 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $7,762.47 | Facility | None | $616.60 | $1,621.81 | $7,762.47 |
BCBS New Mexico Setting Professional Modifier None Typical Low $398.11 Median $812.83 Typical High $1,148.15 | Professional | None | $398.11 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,290.87 | Facility | None | $602.56 | $1,513.56 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,380.38 | Professional | None | $707.95 | $1,071.52 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $707.95 Typical High $1,202.26 | Professional | None | $33.11 | $707.95 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $2,290.87 | Facility | None | $602.56 | $1,479.11 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,380.38 | Professional | None | $758.58 | $1,122.02 | $1,380.38 |
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 $691.83 Median $1,047.13 Typical High $1,445.44 | Professional | None | $691.83 | $1,047.13 | $1,445.44 |
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 $323.59 Median $398.11 Typical High $489.78 | Professional | 52 · Reduced service | $323.59 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $128.82 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | 54 · Surgery only | $489.78 | $588.84 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $120.23 Typical High $147.91 | Professional | 55 · Aftercare only | $97.72 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $549.54 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $457.09 | $549.54 | $691.83 |
Where New Mexico sits
The same service costs 3.1 times more in Alaska than in Maryland. 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
AK $5,990MD $1,938
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.