How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,047 to $10,000Professionalmedian $575 · 10th to 90th $407 to $813
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 $489.78 Median $2,089.30 Typical High $8,912.51 | Facility | None | $489.78 | $2,089.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $776.25 | Professional | None | $446.68 | $616.60 | $776.25 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,202.26 Median $2,570.40 Typical High $12,589.25 | Facility | None | $1,202.26 | $2,570.40 | $12,589.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $812.83 | Professional | None | $426.58 | $575.44 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $2,187.76 Typical High $3,311.31 | Facility | None | $1,047.13 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $776.25 | Professional | None | $457.09 | $537.03 | $776.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $691.83 | Professional | None | $33.11 | $138.04 | $691.83 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,137.96 Typical High $4,365.16 | Facility | None | $537.03 | $2,137.96 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $851.14 | Professional | None | $457.09 | $537.03 | $851.14 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $851.14 | Professional | None | $416.87 | $645.65 | $851.14 |
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 $218.78 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $218.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $89.13 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $331.13 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $66.07 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $44.67 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $309.03 | $426.58 | $426.58 |
Where New Mexico sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.