How much rates vary
Facilitymedian $6,310 · 10th to 90th $933 to $15,488Professionalmedian $794 · 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 $660.69 Median $2,041.74 Typical High $7,762.47 | Facility | None | $660.69 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | None | $588.84 | $851.14 | $851.14 |
BCBS New Mexico Setting Facility Modifier None Typical Low $3,235.94 Median $11,481.54 Typical High $17,782.79 | Facility | None | $3,235.94 | $11,481.54 | $17,782.79 |
BCBS New Mexico Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,122.02 | Professional | None | $588.84 | $794.33 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,309.57 Typical High $8,912.51 | Facility | None | $776.25 | $6,309.57 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,096.48 | Professional | None | $616.60 | $741.31 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $186.21 Typical High $933.25 | Professional | None | $33.11 | $186.21 | $933.25 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,754.23 Typical High $9,120.11 | Facility | None | $660.69 | $2,754.23 | $9,120.11 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,174.90 | Professional | None | $616.60 | $741.31 | $1,174.90 |
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 $575.44 Median $891.25 Typical High $1,174.90 | Professional | None | $575.44 | $891.25 | $1,174.90 |
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 $295.12 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $295.12 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $120.23 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $446.68 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $89.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $58.88 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $416.87 | $588.84 | $588.84 |
Where New Mexico sits
The same service costs 5.4 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 $11,142MT $2,070
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.