How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $17,783Professionalmedian $692 · 10th to 90th $417 to $977
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 $588.84 Median $2,041.74 Typical High $7,762.47 | Facility | None | $588.84 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $870.96 | Professional | None | $524.81 | $741.31 | $870.96 |
BCBS New Mexico Setting Facility Modifier None Typical Low $758.58 Median $2,570.40 Typical High $21,877.62 | Facility | None | $758.58 | $2,570.40 | $21,877.62 |
BCBS New Mexico Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $912.01 | Professional | None | $416.87 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $3,311.31 | Facility | None | $776.25 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $954.99 | Professional | None | $549.54 | $645.65 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $831.76 | Professional | None | $33.11 | $165.96 | $831.76 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $3,311.31 | Facility | None | $537.03 | $1,905.46 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,047.13 | Professional | None | $549.54 | $660.69 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $15,848.93 | Facility | None | $1,995.26 | $5,495.41 | $15,848.93 |
United Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,047.13 | Professional | None | $512.86 | $794.33 | $1,047.13 |
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 $269.15 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $269.15 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $107.15 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $398.11 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $79.43 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $53.70 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $371.54 | $524.81 | $524.81 |
Where New Mexico sits
The same service costs 4.7 times more in Oklahoma 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
OK $8,820MT $1,888
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.