How much rates vary
Facilitymedian $1,778 · 10th to 90th $646 to $8,318Professionalmedian $1,000 · 10th to 90th $646 to $1,380
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 $776.25 Median $1,380.38 Typical High $7,762.47 | Facility | None | $776.25 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $691.83 | $1,000.00 | $1,000.00 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,862.09 Median $6,606.93 Typical High $10,232.93 | Facility | None | $1,862.09 | $6,606.93 | $10,232.93 |
BCBS New Mexico Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,412.54 | Professional | None | $724.44 | $912.01 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,513.56 | Facility | None | $776.25 | $1,174.90 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,318.26 | Professional | None | $758.58 | $912.01 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $218.78 Typical High $1,096.48 | Professional | None | $33.11 | $218.78 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,778.28 | Facility | None | $776.25 | $1,148.15 | $1,778.28 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,445.44 | Professional | None | $758.58 | $912.01 | $1,445.44 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,380.38 | Professional | None | $707.95 | $1,071.52 | $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 $354.81 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $354.81 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $537.03 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $107.15 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $501.19 | $707.95 | $707.95 |
Where New Mexico sits
The same service costs 3.6 times more in Alaska than in Alabama. 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 $5,545AL $1,558
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.