How much rates vary
Facilitymedian $1,202 · 10th to 90th $479 to $4,266Professionalmedian $339 · 10th to 90th $170 to $912
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 $288.40 Median $1,000.00 Typical High $5,011.87 | Facility | None | $288.40 | $1,000.00 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $912.01 | Professional | None | $213.80 | $316.23 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $213.80 | Professional | None | $158.49 | $173.78 | $213.80 |
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 $158.49 Median $263.03 Typical High $707.95 | Professional | None | $158.49 | $263.03 | $707.95 |
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 $239.88 Median $338.84 Typical High $870.96 | Professional | None | $239.88 | $338.84 | $870.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $512.86 Typical High $851.14 | Professional | None | $33.11 | $512.86 | $851.14 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $1,174.90 Typical High $1,819.70 | Facility | None | $275.42 | $1,174.90 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $870.96 | Professional | None | $239.88 | $354.81 | $870.96 |
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 $251.19 Median $426.58 Typical High $1,023.29 | Professional | None | $251.19 | $426.58 | $1,023.29 |
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 $107.15 Median $151.36 Typical High $457.09 | Professional | 52 · Reduced service | $107.15 | $151.36 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $60.26 Typical High $181.97 | Professional | 53 · Discontinued | $42.66 | $60.26 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $223.87 Typical High $676.08 | Professional | 54 · Surgery only | $162.18 | $223.87 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $45.71 Typical High $134.90 | Professional | 55 · Aftercare only | $32.36 | $45.71 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $21.38 | $30.20 | $91.20 |
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 $4,259MT $1,038
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.