How much rates vary
Facilitymedian $2,138 · 10th to 90th $437 to $8,913Professionalmedian $339 · 10th to 90th $251 to $525
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 $275.42 Median $1,047.13 Typical High $7,762.47 | Facility | None | $275.42 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $354.81 | Professional | None | $251.19 | $354.81 | $354.81 |
BCBS New Mexico Setting Facility Modifier None Typical Low $398.11 Median $2,238.72 Typical High $10,715.19 | Facility | None | $398.11 | $2,238.72 | $10,715.19 |
BCBS New Mexico Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $416.87 | Professional | None | $269.15 | $323.59 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $2,630.27 | Facility | None | $537.03 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $489.78 | Professional | None | $281.84 | $354.81 | $489.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $389.05 Typical High $588.84 | Professional | None | $33.11 | $389.05 | $588.84 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $1,288.25 Typical High $2,754.23 | Facility | None | $436.52 | $1,288.25 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $537.03 | Professional | None | $281.84 | $354.81 | $537.03 |
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 $263.03 Median $389.05 Typical High $512.86 | Professional | None | $263.03 | $389.05 | $512.86 |
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 $131.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $53.70 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $199.53 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $39.81 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.92 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $186.21 | $251.19 | $251.19 |
Where New Mexico sits
The same service costs 7.3 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 $6,269MT $863
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.