How much rates vary
Facilitymedian $1,445 · 10th to 90th $575 to $5,012Professionalmedian $398 · 10th to 90th $81 to $490
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 $302.00 Median $1,380.38 Typical High $7,762.47 | Facility | None | $302.00 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | None | $275.42 | $407.38 | $407.38 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $5,495.41 | Facility | None | $1,000.00 | $3,548.13 | $5,495.41 |
BCBS New Mexico Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $691.83 | Professional | None | $275.42 | $338.84 | $691.83 |
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 $309.03 Median $371.54 Typical High $489.78 | Professional | None | $309.03 | $371.54 | $489.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $81.28 Typical High $407.38 | Professional | None | $33.11 | $81.28 | $407.38 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,174.90 Typical High $1,819.70 | Facility | None | $302.00 | $1,174.90 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $501.19 | Professional | None | $323.59 | $380.19 | $501.19 |
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 $288.40 Median $416.87 Typical High $549.54 | Professional | None | $288.40 | $416.87 | $549.54 |
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 $138.04 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $138.04 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $54.95 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $204.17 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $40.74 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $27.54 | $40.74 | $40.74 |
Where New Mexico sits
The same service costs 5.2 times more in Oklahoma 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
OK $4,508MT $873
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.