How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,072 to $20,893Professionalmedian $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 $812.83 Median $2,089.30 Typical High $8,912.51 | Facility | None | $812.83 | $2,089.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,023.29 | Professional | None | $724.44 | $1,023.29 | $1,023.29 |
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 $691.83 Median $954.99 Typical High $1,318.26 | Professional | None | $691.83 | $954.99 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,047.13 | $3,467.37 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,348.96 | Professional | None | $776.25 | $933.25 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $229.09 Typical High $1,148.15 | Professional | None | $33.11 | $229.09 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $6,165.95 | Facility | None | $741.31 | $3,467.37 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,479.11 | Professional | None | $776.25 | $933.25 | $1,479.11 |
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 $707.95 Median $1,122.02 Typical High $1,445.44 | Professional | None | $707.95 | $1,122.02 | $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 $371.54 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $371.54 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $147.91 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $549.54 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $109.65 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $74.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $512.86 | $724.44 | $724.44 |
Where New Mexico sits
The same service costs 4.9 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 $10,315KY $2,095
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.