How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,349 to $22,387Professionalmedian $1,585 · 10th to 90th $1,122 to $2,239
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 $1,000.00 Median $2,089.30 Typical High $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,659.59 | $1,659.59 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,677.35 Median $16,982.44 Typical High $25,703.96 | Facility | None | $4,677.35 | $16,982.44 | $25,703.96 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,548.82 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,265.80 Typical High $6,025.60 | Facility | None | $741.31 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,513.56 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $371.54 Typical High $1,862.09 | Professional | None | $33.11 | $371.54 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $6,165.95 | Facility | None | $741.31 | $3,090.30 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,513.56 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,786.30 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,778.28 | $2,344.23 |
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 $588.84 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $588.84 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $234.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $891.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $177.83 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $117.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $831.76 | $1,174.90 | $1,174.90 |
Where New Mexico sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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 $14,661HI $3,664
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.