How much rates vary
Facilitymedian $14,454 · 10th to 90th $1,000 to $66,069Professionalmedian $2,344 · 10th to 90th $1,660 to $3,236
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 $8,912.51 | Facility | None | $1,000.00 | $2,089.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,584.89 | $2,344.23 | $2,344.23 |
BCBS New Mexico Setting Facility Modifier None Typical Low $13,489.63 Median $48,977.88 Typical High $75,857.76 | Facility | None | $13,489.63 | $48,977.88 | $75,857.76 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,659.59 | $2,137.96 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,803.84 Typical High $19,498.45 | Facility | None | $602.56 | $13,803.84 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,778.28 | $2,089.30 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $2,570.40 Typical High $2,570.40 | Professional | None | $33.11 | $2,570.40 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $14,454.40 Typical High $20,417.38 | Facility | None | $602.56 | $14,454.40 | $20,417.38 |
Providence Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,089.30 | $3,311.31 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $10,232.93 Typical High $27,542.29 | Facility | None | $3,981.07 | $10,232.93 | $27,542.29 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $3,467.37 | Professional | None | $1,819.70 | $2,570.40 | $3,467.37 |
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 $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $794.33 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $323.59 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,202.26 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $239.88 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $158.49 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,621.81 | $1,621.81 |
Where New Mexico sits
The same service costs 7.8 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 $31,233KY $3,989
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.