How much rates vary
Facilitymedian $5,495 · 10th to 90th $759 to $18,197Professionalmedian $676 · 10th to 90th $437 to $891
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 $575.44 Median $977.24 Typical High $7,762.47 | Facility | None | $575.44 | $977.24 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $741.31 | Professional | None | $512.86 | $724.44 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
BCBS New Mexico Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $21,877.62 | Facility | None | $758.58 | $6,165.95 | $21,877.62 |
BCBS New Mexico Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $812.83 | Professional | None | $436.52 | $676.08 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,495.41 Typical High $7,762.47 | Facility | None | $776.25 | $5,495.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $891.25 | Professional | None | $537.03 | $630.96 | $891.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $162.18 Typical High $812.83 | Professional | None | $33.11 | $162.18 | $812.83 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,754.23 Typical High $7,943.28 | Facility | None | $537.03 | $2,754.23 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $977.24 | Professional | None | $537.03 | $630.96 | $977.24 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,000.00 | Professional | None | $478.63 | $741.31 | $1,000.00 |
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 $257.04 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $257.04 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $102.33 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $389.05 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $51.29 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $363.08 | $501.19 | $501.19 |
Where New Mexico sits
The same service costs 7.5 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 $13,659MT $1,825
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.