How much rates vary
Facilitymedian $3,981 · 10th to 90th $759 to $8,913Professionalmedian $603 · 10th to 90th $295 to $912
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 $407.38 Median $1,000.00 Typical High $7,762.47 | Facility | None | $407.38 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $758.58 | Professional | None | $407.38 | $537.03 | $758.58 |
BCBS New Mexico Setting Facility Modifier None Typical Low $758.58 Median $4,677.35 Typical High $10,715.19 | Facility | None | $758.58 | $4,677.35 | $10,715.19 |
BCBS New Mexico Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $758.58 | Professional | None | $295.12 | $489.78 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,265.80 Typical High $6,025.60 | Facility | None | $776.25 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $912.01 | Professional | None | $457.09 | $630.96 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $512.86 Typical High $851.14 | Professional | None | $33.11 | $512.86 | $851.14 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,754.23 Typical High $6,165.95 | Facility | None | $537.03 | $2,754.23 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $977.24 | Professional | None | $457.09 | $630.96 | $977.24 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,047.13 | Professional | None | $446.68 | $660.69 | $1,047.13 |
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 $204.17 Median $269.15 Typical High $380.19 | Professional | 52 · Reduced service | $204.17 | $269.15 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $154.88 | Professional | 53 · Discontinued | $83.18 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $575.44 | Professional | 54 · Surgery only | $309.03 | $398.11 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $114.82 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $53.70 Typical High $75.86 | Professional | 56 · Pre-op care only | $40.74 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $371.54 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $288.40 | $371.54 | $537.03 |
Where New Mexico sits
The same service costs 6.5 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 $9,949MT $1,532
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.