How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,000 to $23,988Professionalmedian $708 · 10th to 90th $427 to $955
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 $549.54 Median $1,548.82 Typical High $8,709.64 | Facility | None | $549.54 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | None | $501.19 | $707.95 | $707.95 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,897.79 Median $17,782.79 Typical High $26,915.35 | Facility | None | $4,897.79 | $17,782.79 | $26,915.35 |
BCBS New Mexico Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,023.29 | Professional | None | $501.19 | $831.76 | $1,023.29 |
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 $524.81 Median $630.96 Typical High $912.01 | Professional | None | $524.81 | $630.96 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $158.49 Typical High $794.33 | Professional | None | $33.11 | $158.49 | $794.33 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $2,238.72 Typical High $6,165.95 | Facility | None | $562.34 | $2,238.72 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,000.00 | Professional | None | $524.81 | $630.96 | $1,000.00 |
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 $977.24 | Professional | None | $478.63 | $741.31 | $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 $251.19 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $251.19 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $75.86 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $50.12 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $354.81 | $501.19 | $501.19 |
Where New Mexico sits
The same service costs 7.9 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 $13,941MT $1,762
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.