How much rates vary
Facilitymedian $2,239 · 10th to 90th $676 to $12,589Professionalmedian $794 · 10th to 90th $589 to $1,148
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 $660.69 Median $1,380.38 Typical High $7,762.47 | Facility | None | $660.69 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $851.14 | Professional | None | $602.56 | $851.14 | $851.14 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $2,570.40 Typical High $15,488.17 | Facility | None | $537.03 | $2,570.40 | $15,488.17 |
BCBS New Mexico Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,023.29 | Professional | None | $630.96 | $794.33 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $2,630.27 | Facility | None | $776.25 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,148.15 | Professional | None | $660.69 | $794.33 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $954.99 | Professional | None | $33.11 | $190.55 | $954.99 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,258.93 | Professional | None | $660.69 | $794.33 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,235.94 | $10,471.29 |
United Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,202.26 | Professional | None | $616.60 | $933.25 | $1,202.26 |
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 $309.03 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $602.56 | $602.56 |
Where New Mexico sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.