How much rates vary
Facilitymedian $2,138 · 10th to 90th $617 to $8,913Professionalmedian $537 · 10th to 90th $282 to $832
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 $371.54 Median $1,548.82 Typical High $8,709.64 | Facility | None | $371.54 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $691.83 | Professional | None | $371.54 | $489.78 | $691.83 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $2,238.72 Typical High $10,715.19 | Facility | None | $616.60 | $2,238.72 | $10,715.19 |
BCBS New Mexico Setting Professional Modifier None Typical Low $281.84 Median $467.74 Typical High $691.83 | Professional | None | $281.84 | $467.74 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $831.76 | Professional | None | $407.38 | $575.44 | $831.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $457.09 Typical High $758.58 | Professional | None | $33.11 | $457.09 | $758.58 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $2,754.23 | Facility | None | $537.03 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $891.25 | Professional | None | $407.38 | $575.44 | $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 $398.11 Median $588.84 Typical High $954.99 | Professional | None | $398.11 | $588.84 | $954.99 |
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 $181.97 Median $239.88 Typical High $346.74 | Professional | 52 · Reduced service | $181.97 | $239.88 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $138.04 | Professional | 53 · Discontinued | $74.13 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $363.08 Typical High $512.86 | Professional | 54 · Surgery only | $275.42 | $363.08 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $72.44 Typical High $102.33 | Professional | 55 · Aftercare only | $54.95 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $69.18 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $338.84 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $257.04 | $338.84 | $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 $6,438MT $1,383
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.