How much rates vary
Facilitymedian $4,074 · 10th to 90th $617 to $8,913Professionalmedian $537 · 10th to 90th $269 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 $371.54 Median $1,548.82 Typical High $8,709.64 | Facility | None | $371.54 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $691.83 | Professional | None | $363.08 | $501.19 | $691.83 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $4,677.35 Typical High $10,715.19 | Facility | None | $616.60 | $4,677.35 | $10,715.19 |
BCBS New Mexico Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $645.65 | Professional | None | $257.04 | $436.52 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $812.83 | Professional | None | $398.11 | $562.34 | $812.83 |
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 $489.78 Median $2,238.72 Typical High $6,165.95 | Facility | None | $489.78 | $2,238.72 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $851.14 | Professional | None | $398.11 | $575.44 | $851.14 |
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 $398.11 Median $575.44 Typical High $912.01 | Professional | None | $398.11 | $575.44 | $912.01 |
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 $186.21 Median $234.42 Typical High $346.74 | Professional | 52 · Reduced service | $186.21 | $234.42 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $138.04 | Professional | 53 · Discontinued | $74.13 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $354.81 Typical High $512.86 | Professional | 54 · Surgery only | $275.42 | $354.81 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $102.33 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $69.18 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $331.13 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $257.04 | $331.13 | $478.63 |
Where New Mexico sits
The same service costs 6.4 times more in Alaska 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
AK $8,723MT $1,361
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.