How much rates vary
Facilitymedian $5,129 · 10th to 90th $871 to $11,482Professionalmedian $1,122 · 10th to 90th $692 to $1,514
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 $912.01 Median $2,041.74 Typical High $7,762.47 | Facility | None | $912.01 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | None | $794.33 | $1,148.15 | $1,148.15 |
BCBS New Mexico Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $13,803.84 | Facility | None | $758.58 | $5,888.44 | $13,803.84 |
BCBS New Mexico Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,584.89 | Professional | None | $776.25 | $1,047.13 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,370.32 Typical High $7,585.78 | Facility | None | $776.25 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,380.38 | Professional | None | $831.76 | $1,000.00 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $251.19 Typical High $1,258.93 | Professional | None | $33.11 | $251.19 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $7,943.28 | Facility | None | $776.25 | $2,754.23 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,513.56 | Professional | None | $831.76 | $1,000.00 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $14,125.38 | Facility | None | $1,230.27 | $3,235.94 | $14,125.38 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,548.82 | Professional | None | $758.58 | $1,148.15 | $1,548.82 |
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 $398.11 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $398.11 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $602.56 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $79.43 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $562.34 | $794.33 | $794.33 |
Where New Mexico sits
The same service costs 4.5 times more in Alaska 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
AK $12,963MT $2,892
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.