How much rates vary
Facilitymedian $1,905 · 10th to 90th $603 to $3,715Professionalmedian $617 · 10th to 90th $398 to $832
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 $489.78 Median $1,548.82 Typical High $8,709.64 | Facility | None | $489.78 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $616.60 | Professional | None | $436.52 | $616.60 | $616.60 |
BCBS New Mexico Setting Facility Modifier None Typical Low $549.54 Median $1,778.28 Typical High $2,630.27 | Facility | None | $549.54 | $1,778.28 | $2,630.27 |
BCBS New Mexico Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $870.96 | Professional | None | $436.52 | $575.44 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $794.33 | Professional | None | $457.09 | $549.54 | $794.33 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $691.83 | Professional | None | $33.11 | $138.04 | $691.83 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $2,754.23 | Facility | None | $537.03 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $870.96 | Professional | None | $457.09 | $549.54 | $870.96 |
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 $416.87 Median $660.69 Typical High $851.14 | Professional | None | $416.87 | $660.69 | $851.14 |
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 $218.78 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $218.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $87.10 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $331.13 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $66.07 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $43.65 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $309.03 | $436.52 | $436.52 |
Where New Mexico sits
The same service costs 4.6 times more in Alabama 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
AL $7,006MT $1,517
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.