How much rates vary
Facilitymedian $2,344 · 10th to 90th $776 to $11,220Professionalmedian $617 · 10th to 90th $363 to $912
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 $416.87 Median $1,380.38 Typical High $7,762.47 | Facility | None | $416.87 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $741.31 | Professional | None | $416.87 | $537.03 | $741.31 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,344.23 Median $8,511.38 Typical High $13,182.57 | Facility | None | $2,344.23 | $8,511.38 | $13,182.57 |
BCBS New Mexico Setting Professional Modifier None Typical Low $295.12 Median $758.58 Typical High $1,202.26 | Professional | None | $295.12 | $758.58 | $1,202.26 |
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 $457.09 Median $630.96 Typical High $870.96 | Professional | None | $457.09 | $630.96 | $870.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $501.19 Typical High $831.76 | Professional | None | $33.11 | $501.19 | $831.76 |
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 $457.09 Median $630.96 Typical High $933.25 | Professional | None | $457.09 | $630.96 | $933.25 |
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 $436.52 Median $645.65 Typical High $977.24 | Professional | None | $436.52 | $645.65 | $977.24 |
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 $208.93 Median $269.15 Typical High $371.54 | Professional | 52 · Reduced service | $208.93 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $147.91 | Professional | 53 · Discontinued | $83.18 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $398.11 Typical High $562.34 | Professional | 54 · Surgery only | $316.23 | $398.11 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $112.20 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $74.13 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $371.54 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $295.12 | $371.54 | $524.81 |
Where New Mexico sits
The same service costs 4.4 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 $6,491MT $1,489
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.