How much rates vary
Facilitymedian $2,089 · 10th to 90th $562 to $8,913Professionalmedian $562 · 10th to 90th $295 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 $363.08 Median $1,380.38 Typical High $7,762.47 | Facility | None | $363.08 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $691.83 | Professional | None | $363.08 | $524.81 | $691.83 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $2,238.72 Typical High $10,715.19 | Facility | None | $537.03 | $2,238.72 | $10,715.19 |
BCBS New Mexico Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $645.65 | Professional | None | $295.12 | $489.78 | $645.65 |
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 $398.11 Median $575.44 Typical High $891.25 | Professional | None | $398.11 | $575.44 | $891.25 |
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 $380.19 Median $1,513.56 Typical High $2,754.23 | Facility | None | $380.19 | $1,513.56 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $954.99 | Professional | None | $416.87 | $602.56 | $954.99 |
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 $389.05 Median $616.60 Typical High $1,023.29 | Professional | None | $389.05 | $616.60 | $1,023.29 |
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 $234.42 Typical High $346.74 | Professional | 52 · Reduced service | $181.97 | $234.42 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $138.04 | Professional | 53 · Discontinued | $72.44 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $354.81 Typical High $524.81 | Professional | 54 · Surgery only | $269.15 | $354.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $70.79 Typical High $104.71 | Professional | 55 · Aftercare only | $53.70 | $70.79 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $69.18 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $331.13 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $251.19 | $331.13 | $489.78 |
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 $6,451MT $1,460
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.