How much rates vary
Facilitymedian $6,026 · 10th to 90th $759 to $33,113Professionalmedian $912 · 10th to 90th $676 to $1,288
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 $776.25 Median $1,548.82 Typical High $8,709.64 | Facility | None | $776.25 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $691.83 | $1,000.00 | $1,000.00 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $7,585.78 Typical High $42,657.95 | Facility | None | $616.60 | $7,585.78 | $42,657.95 |
BCBS New Mexico Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,148.15 | Professional | None | $691.83 | $912.01 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $7,762.47 | Facility | None | $602.56 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,288.25 | Professional | None | $741.31 | $891.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $218.78 Typical High $1,071.52 | Professional | None | $33.11 | $218.78 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $8,128.31 | Facility | None | $602.56 | $2,238.72 | $8,128.31 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,412.54 | Professional | None | $741.31 | $891.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,380.38 | Professional | None | $691.83 | $1,047.13 | $1,380.38 |
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 $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $346.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $512.86 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $104.71 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $478.63 | $691.83 | $691.83 |
Where New Mexico sits
The same service costs 6.0 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 $14,230MT $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.