How much rates vary
Facilitymedian $4,571 · 10th to 90th $776 to $18,621Professionalmedian $891 · 10th to 90th $676 to $1,349
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 $758.58 Median $2,041.74 Typical High $7,762.47 | Facility | None | $758.58 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,122.02 | Professional | None | $676.08 | $977.24 | $1,122.02 |
BCBS New Mexico Setting Facility Modifier None Typical Low $758.58 Median $4,786.30 Typical High $22,387.21 | Facility | None | $758.58 | $4,786.30 | $22,387.21 |
BCBS New Mexico Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,148.15 | Professional | None | $676.08 | $891.25 | $1,148.15 |
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 $724.44 Median $870.96 Typical High $1,288.25 | Professional | None | $724.44 | $870.96 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,071.52 Typical High $1,621.81 | Professional | None | $33.11 | $1,071.52 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $6,165.95 | Facility | None | $758.58 | $2,754.23 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,380.38 | Professional | None | $724.44 | $870.96 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,786.30 | $14,125.38 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,348.96 | Professional | None | $676.08 | $1,047.13 | $1,348.96 |
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 $346.74 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $346.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $138.04 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $524.81 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $104.71 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $69.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $489.78 | $676.08 | $676.08 |
Where New Mexico sits
The same service costs 5.7 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 $13,613MT $2,377
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.