How much rates vary
Facilitymedian $1,175 · 10th to 90th $479 to $4,266Professionalmedian $282 · 10th to 90th $126 to $692
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 $281.84 Median $954.99 Typical High $5,011.87 | Facility | None | $281.84 | $954.99 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $724.44 | Professional | None | $194.98 | $281.84 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $489.78 | Professional | None | $85.11 | $169.82 | $489.78 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $1,288.25 Typical High $4,265.80 | Facility | None | $537.03 | $1,288.25 | $4,265.80 |
BCBS New Mexico Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $575.44 | Professional | None | $123.03 | $234.42 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,513.56 | Facility | None | $776.25 | $1,202.26 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $691.83 | Professional | None | $229.09 | $309.03 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $407.38 Typical High $676.08 | Professional | None | $33.11 | $407.38 | $676.08 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $1,174.90 Typical High $1,819.70 | Facility | None | $251.19 | $1,174.90 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $691.83 | Professional | None | $234.42 | $309.03 | $691.83 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $758.58 | Professional | None | $223.87 | $346.74 | $758.58 |
5 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 $102.33 Median $147.91 Typical High $354.81 | Professional | 52 · Reduced service | $102.33 | $147.91 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $58.88 Typical High $144.54 | Professional | 53 · Discontinued | $40.74 | $58.88 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $218.78 Typical High $537.03 | Professional | 54 · Surgery only | $151.36 | $218.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $43.65 Typical High $107.15 | Professional | 55 · Aftercare only | $30.90 | $43.65 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $29.51 Typical High $72.44 | Professional | 56 · Pre-op care only | $20.42 | $29.51 | $72.44 |
Where New Mexico sits
The same service costs 4.1 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 $4,142MT $1,002
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.