How much rates vary
Facilitymedian $1,622 · 10th to 90th $562 to $7,762Professionalmedian $550 · 10th to 90th $295 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 $398.11 Median $1,380.38 Typical High $7,762.47 | Facility | None | $398.11 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $691.83 | Professional | None | $398.11 | $512.86 | $691.83 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $9,332.54 | Facility | None | $537.03 | $1,905.46 | $9,332.54 |
BCBS New Mexico Setting Professional Modifier None Typical Low $281.84 Median $467.74 Typical High $724.44 | Professional | None | $281.84 | $467.74 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,445.44 Typical High $1,995.26 | Facility | None | $776.25 | $1,445.44 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $812.83 | Professional | None | $436.52 | $588.84 | $812.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $446.68 Typical High $741.31 | Professional | None | $33.11 | $446.68 | $741.31 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $1,445.44 Typical High $2,089.30 | Facility | None | $467.74 | $1,445.44 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $891.25 | Professional | None | $436.52 | $588.84 | $891.25 |
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 $407.38 Median $616.60 Typical High $912.01 | Professional | None | $407.38 | $616.60 | $912.01 |
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 $199.53 Median $257.04 Typical High $338.84 | Professional | 52 · Reduced service | $199.53 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $102.33 Typical High $138.04 | Professional | 53 · Discontinued | $79.43 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $512.86 | Professional | 54 · Surgery only | $302.00 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $75.86 Typical High $102.33 | Professional | 55 · Aftercare only | $60.26 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $51.29 Typical High $69.18 | Professional | 56 · Pre-op care only | $39.81 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $281.84 | $354.81 | $478.63 |
Where New Mexico sits
The same service costs 4.7 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 $6,464MT $1,390
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.