How much rates vary
Facilitymedian $1,905 · 10th to 90th $617 to $4,898Professionalmedian $1,047 · 10th to 90th $575 to $1,318
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 $831.76 Median $1,548.82 Typical High $8,709.64 | Facility | None | $831.76 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | None | $724.44 | $1,047.13 | $1,047.13 |
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 |
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 $741.31 Median $912.01 Typical High $1,258.93 | Professional | None | $741.31 | $912.01 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $229.09 Typical High $1,122.02 | Professional | None | $33.11 | $229.09 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,754.23 | Facility | None | $602.56 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,348.96 | Professional | None | $741.31 | $912.01 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,235.94 | $10,471.29 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,380.38 | Professional | None | $676.08 | $1,047.13 | $1,380.38 |
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 $363.08 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $363.08 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $537.03 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $107.15 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $501.19 | $724.44 | $724.44 |
Where New Mexico sits
The same service costs 3.1 times more in Wisconsin 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
WI $7,619HI $2,493
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.