How much rates vary
Facilitymedian $2,344 · 10th to 90th $692 to $10,471Professionalmedian $550 · 10th to 90th $275 to $813
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 $380.19 Median $1,380.38 Typical High $7,762.47 | Facility | None | $380.19 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $691.83 | Professional | None | $380.19 | $478.63 | $691.83 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,187.76 Median $7,943.28 Typical High $12,302.69 | Facility | None | $2,187.76 | $7,943.28 | $12,302.69 |
BCBS New Mexico Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $707.95 | Professional | None | $257.04 | $436.52 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $2,630.27 | Facility | None | $776.25 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $794.33 | Professional | None | $398.11 | $562.34 | $794.33 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $457.09 Typical High $758.58 | Professional | None | $33.11 | $457.09 | $758.58 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,513.56 Typical High $2,754.23 | Facility | None | $416.87 | $1,513.56 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $851.14 | Professional | None | $398.11 | $562.34 | $851.14 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $891.25 | Professional | None | $398.11 | $575.44 | $891.25 |
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 $190.55 Median $239.88 Typical High $346.74 | Professional | 52 · Reduced service | $190.55 | $239.88 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $138.04 | Professional | 53 · Discontinued | $75.86 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $354.81 Typical High $524.81 | Professional | 54 · Surgery only | $281.84 | $354.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $70.79 Typical High $104.71 | Professional | 55 · Aftercare only | $56.23 | $70.79 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $69.18 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $331.13 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $263.03 | $331.13 | $489.78 |
Where New Mexico sits
The same service costs 4.8 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 $6,438MT $1,344
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.