How much rates vary
Facilitymedian $4,074 · 10th to 90th $676 to $9,120Professionalmedian $575 · 10th to 90th $437 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 $478.63 Median $1,380.38 Typical High $7,762.47 | Facility | None | $478.63 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $724.44 | Professional | None | $436.52 | $616.60 | $724.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $4,677.35 Typical High $10,715.19 | Facility | None | $537.03 | $4,677.35 | $10,715.19 |
BCBS New Mexico Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $741.31 | Professional | None | $457.09 | $575.44 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,265.80 Typical High $6,025.60 | Facility | None | $776.25 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $831.76 | Professional | None | $478.63 | $602.56 | $831.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $691.83 | Professional | None | $33.11 | $138.04 | $691.83 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $1,513.56 Typical High $6,165.95 | Facility | None | $741.31 | $1,513.56 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $912.01 | Professional | None | $478.63 | $602.56 | $912.01 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $851.14 | Professional | None | $457.09 | $660.69 | $851.14 |
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 $229.09 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $229.09 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $91.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $338.84 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $67.61 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $45.71 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $316.23 | $426.58 | $426.58 |
Where New Mexico sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.