How much rates vary
Facilitymedian $1,905 · 10th to 90th $550 to $3,715Professionalmedian $407 · 10th to 90th $234 to $631
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 $269.15 Median $1,548.82 Typical High $8,709.64 | Facility | None | $269.15 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $512.86 | Professional | None | $263.03 | $338.84 | $512.86 |
BCBS New Mexico Setting Facility Modifier None Typical Low $549.54 Median $1,778.28 Typical High $2,630.27 | Facility | None | $549.54 | $1,778.28 | $2,630.27 |
BCBS New Mexico Setting Professional Modifier None Typical Low $181.97 Median $354.81 Typical High $602.56 | Professional | None | $181.97 | $354.81 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $616.60 | Professional | None | $295.12 | $416.87 | $616.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $338.84 Typical High $562.34 | Professional | None | $33.11 | $338.84 | $562.34 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $1,905.46 Typical High $2,754.23 | Facility | None | $371.54 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $645.65 | Professional | None | $295.12 | $426.58 | $645.65 |
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 $295.12 Median $426.58 Typical High $691.83 | Professional | None | $295.12 | $426.58 | $691.83 |
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 $134.90 Median $177.83 Typical High $257.04 | Professional | 52 · Reduced service | $134.90 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $70.79 Typical High $102.33 | Professional | 53 · Discontinued | $53.70 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $263.03 Typical High $380.19 | Professional | 54 · Surgery only | $204.17 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $52.48 Typical High $75.86 | Professional | 55 · Aftercare only | $40.74 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $35.48 Typical High $51.29 | Professional | 56 · Pre-op care only | $26.92 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $245.47 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $190.55 | $245.47 | $354.81 |
Where New Mexico sits
The same service costs 6.3 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 $6,296MT $1,002
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.