How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,230 to $16,596Professionalmedian $1,380 · 10th to 90th $724 to $1,950
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 $1,000.00 Median $1,380.38 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,513.56 | $1,513.56 |
BCBS New Mexico Setting Facility Modifier None Typical Low $3,235.94 Median $11,481.54 Typical High $17,782.79 | Facility | None | $3,235.94 | $11,481.54 | $17,782.79 |
BCBS New Mexico Setting Professional Modifier None Typical Low $724.44 Median $1,380.38 Typical High $1,737.80 | Professional | None | $724.44 | $1,380.38 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $10,232.93 Typical High $14,454.40 | Facility | None | $776.25 | $10,232.93 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,380.38 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $331.13 Typical High $1,659.59 | Professional | None | $33.11 | $331.13 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,584.89 Typical High $14,791.08 | Facility | None | $776.25 | $1,584.89 | $14,791.08 |
Providence Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,380.38 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $15,848.93 | Facility | None | $1,230.27 | $3,235.94 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,621.81 | $2,137.96 |
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 $537.03 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $537.03 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $213.80 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $794.33 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $158.49 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $107.15 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $741.31 | $1,047.13 | $1,047.13 |
Where New Mexico sits
The same service costs 6.9 times more in Alaska 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
AK $18,481HI $2,671
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.