How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,000 to $12,882Professionalmedian $575 · 10th to 90th $457 to $794
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 $489.78 Median $1,548.82 Typical High $8,709.64 | Facility | None | $489.78 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $676.08 | Professional | None | $446.68 | $630.96 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | None | $398.11 | $398.11 | $416.87 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,691.53 Median $9,549.93 Typical High $14,791.08 | Facility | None | $2,691.53 | $9,549.93 | $14,791.08 |
BCBS New Mexico Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $676.08 | Professional | None | $457.09 | $549.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,760.83 | Facility | None | $602.56 | $4,265.80 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $776.25 | Professional | None | $467.74 | $562.34 | $776.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $660.69 Typical High $660.69 | Professional | None | $33.11 | $660.69 | $660.69 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $4,786.30 Typical High $6,760.83 | Facility | None | $602.56 | $4,786.30 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $812.83 | Professional | None | $512.86 | $602.56 | $812.83 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $933.25 | Professional | None | $478.63 | $676.08 | $933.25 |
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 $223.87 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $223.87 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $89.13 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $331.13 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $66.07 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $44.67 | $67.61 | $67.61 |
Where New Mexico sits
The same service costs 6.1 times more in Alaska 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
AK $8,625MT $1,416
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.