How much rates vary
Facilitymedian $5,888 · 10th to 90th $724 to $18,621Professionalmedian $871 · 10th to 90th $631 to $1,230
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 $724.44 Median $1,548.82 Typical High $8,709.64 | Facility | None | $724.44 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,071.52 | Professional | None | $645.65 | $933.25 | $1,071.52 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $6,309.57 Typical High $22,387.21 | Facility | None | $616.60 | $6,309.57 | $22,387.21 |
BCBS New Mexico Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,258.93 | Professional | None | $660.69 | $870.96 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $7,943.28 | Facility | None | $602.56 | $5,623.41 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,230.27 | Professional | None | $691.83 | $831.76 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $204.17 Typical High $1,023.29 | Professional | None | $33.11 | $204.17 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $8,128.31 | Facility | None | $602.56 | $2,238.72 | $8,128.31 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,318.26 | Professional | None | $691.83 | $831.76 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,288.25 | Professional | None | $645.65 | $1,000.00 | $1,288.25 |
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 $331.13 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $331.13 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $131.83 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $489.78 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $97.72 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $66.07 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $457.09 | $645.65 | $645.65 |
Where New Mexico sits
The same service costs 6.1 times more in Colorado 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
CO $13,882MT $2,270
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.