How much rates vary
Facilitymedian $2,138 · 10th to 90th $603 to $10,000Professionalmedian $575 · 10th to 90th $251 to $851
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 $524.81 Median $1,000.00 Typical High $7,762.47 | Facility | None | $524.81 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $724.44 | Professional | None | $407.38 | $524.81 | $724.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $2,511.89 Typical High $12,589.25 | Facility | None | $616.60 | $2,511.89 | $12,589.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $239.88 Median $489.78 Typical High $676.08 | Professional | None | $239.88 | $489.78 | $676.08 |
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 $446.68 Median $616.60 Typical High $851.14 | Professional | None | $446.68 | $616.60 | $851.14 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $478.63 Typical High $794.33 | Professional | None | $33.11 | $478.63 | $794.33 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $2,754.23 | Facility | None | $501.19 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $912.01 | Professional | None | $446.68 | $616.60 | $912.01 |
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 $416.87 Median $630.96 Typical High $977.24 | Professional | None | $416.87 | $630.96 | $977.24 |
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 $208.93 Median $263.03 Typical High $363.08 | Professional | 52 · Reduced service | $208.93 | $263.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $144.54 | Professional | 53 · Discontinued | $83.18 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $389.05 Typical High $537.03 | Professional | 54 · Surgery only | $309.03 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $107.15 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $52.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $41.69 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $363.08 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $288.40 | $363.08 | $501.19 |
Where New Mexico sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.