How much rates vary
Facilitymedian $1,820 · 10th to 90th $575 to $12,023Professionalmedian $457 · 10th to 90th $372 to $631
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 $398.11 Median $602.56 Typical High $7,762.47 | Facility | None | $398.11 | $602.56 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $549.54 | Professional | None | $363.08 | $549.54 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $371.54 Median $446.68 Typical High $524.81 | Professional | None | $371.54 | $446.68 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,819.70 | Facility | None | $602.56 | $1,071.52 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $630.96 | Professional | None | $398.11 | $467.74 | $630.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $537.03 Typical High $537.03 | Professional | None | $33.11 | $537.03 | $537.03 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $5,754.40 | Facility | None | $602.56 | $1,202.26 | $5,754.40 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $660.69 | Professional | None | $416.87 | $489.78 | $660.69 |
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 $389.05 Median $549.54 Typical High $758.58 | Professional | None | $389.05 | $549.54 | $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 $181.97 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $72.44 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $53.70 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $36.31 | $54.95 | $54.95 |
Where New Mexico sits
The same service costs 5.0 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 $5,749MT $1,151
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.