How much rates vary
Facilitymedian $4,571 · 10th to 90th $776 to $18,197Professionalmedian $813 · 10th to 90th $575 to $1,122
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 $676.08 Median $1,122.02 Typical High $7,762.47 | Facility | None | $676.08 | $1,122.02 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $851.14 | Professional | None | $602.56 | $851.14 | $851.14 |
BCBS New Mexico Setting Facility Modifier None Typical Low $758.58 Median $4,786.30 Typical High $21,877.62 | Facility | None | $758.58 | $4,786.30 | $21,877.62 |
BCBS New Mexico Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,148.15 | Professional | None | $588.84 | $794.33 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,265.80 Typical High $6,025.60 | Facility | None | $776.25 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,096.48 | Professional | None | $630.96 | $758.58 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $954.99 | Professional | None | $33.11 | $190.55 | $954.99 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,754.23 Typical High $6,165.95 | Facility | None | $660.69 | $2,754.23 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,202.26 | Professional | None | $630.96 | $758.58 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,202.26 | Professional | None | $575.44 | $891.25 | $1,202.26 |
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 $302.00 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $302.00 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $123.03 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $457.09 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $91.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $60.26 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $426.58 | $602.56 | $602.56 |
Where New Mexico sits
The same service costs 6.5 times more in Colorado 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
CO $13,795MT $2,119
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.