How much rates vary
Facilitymedian $1,514 · 10th to 90th $575 to $8,318Professionalmedian $631 · 10th to 90th $288 to $891
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 $501.19 Median $1,380.38 Typical High $7,762.47 | Facility | None | $501.19 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $707.95 | Professional | None | $478.63 | $645.65 | $707.95 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,862.09 Median $6,606.93 Typical High $10,232.93 | Facility | None | $1,862.09 | $6,606.93 | $10,232.93 |
BCBS New Mexico Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $831.76 | Professional | None | $288.40 | $602.56 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,513.56 | Facility | None | $776.25 | $1,174.90 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $891.25 | Professional | None | $524.81 | $676.08 | $891.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $478.63 Typical High $794.33 | Professional | None | $33.11 | $478.63 | $794.33 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,148.15 Typical High $1,778.28 | Facility | None | $537.03 | $1,148.15 | $1,778.28 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $954.99 | Professional | None | $524.81 | $707.95 | $954.99 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $977.24 | Professional | None | $478.63 | $707.95 | $977.24 |
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 $251.19 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $251.19 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $380.19 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $75.86 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $354.81 | $446.68 | $501.19 |
Where New Mexico sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.