How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,230 to $20,893Professionalmedian $1,122 · 10th to 90th $708 to $1,514
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 $891.25 Median $2,041.74 Typical High $7,762.47 | Facility | None | $891.25 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,365.16 Median $15,488.17 Typical High $23,988.33 | Facility | None | $4,365.16 | $15,488.17 | $23,988.33 |
BCBS New Mexico Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,513.56 | Professional | None | $776.25 | $1,047.13 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,467.37 Typical High $4,897.79 | Facility | None | $776.25 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,513.56 | Professional | None | $870.96 | $1,047.13 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $245.47 Typical High $1,230.27 | Professional | None | $33.11 | $245.47 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,513.56 Typical High $5,128.61 | Facility | None | $776.25 | $1,513.56 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,659.59 | Professional | None | $870.96 | $1,047.13 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,548.82 | Professional | None | $776.25 | $1,202.26 | $1,548.82 |
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 $407.38 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $407.38 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $165.96 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $616.60 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $123.03 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $83.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $575.44 | $776.25 | $776.25 |
Where New Mexico sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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 $10,228KY $2,649
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.