How much rates vary
Facilitymedian $2,089 · 10th to 90th $537 to $8,710Professionalmedian $490 · 10th to 90th $240 to $724
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 $331.13 Median $1,380.38 Typical High $7,762.47 | Facility | None | $331.13 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $616.60 | Professional | None | $331.13 | $436.52 | $616.60 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $2,187.76 Typical High $10,715.19 | Facility | None | $537.03 | $2,187.76 | $10,715.19 |
BCBS New Mexico Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $630.96 | Professional | None | $229.09 | $398.11 | $630.96 |
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 $363.08 Median $512.86 Typical High $724.44 | Professional | None | $363.08 | $512.86 | $724.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $407.38 Typical High $676.08 | Professional | None | $33.11 | $407.38 | $676.08 |
Providence Setting Facility Modifier None Typical Low $389.05 Median $1,513.56 Typical High $2,754.23 | Facility | None | $389.05 | $1,513.56 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $776.25 | Professional | None | $363.08 | $512.86 | $776.25 |
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 $363.08 Median $524.81 Typical High $812.83 | Professional | None | $363.08 | $524.81 | $812.83 |
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 $165.96 Median $208.93 Typical High $309.03 | Professional | 52 · Reduced service | $165.96 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $123.03 | Professional | 53 · Discontinued | $66.07 | $83.18 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $457.09 | Professional | 54 · Surgery only | $251.19 | $316.23 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $91.20 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $61.66 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $426.58 |
Where New Mexico sits
The same service costs 5.3 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 $6,378MT $1,213
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.