How much rates vary
Facilitymedian $1,288 · 10th to 90th $562 to $4,677Professionalmedian $245 · 10th to 90th $166 to $372
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 $181.97 Median $1,047.13 Typical High $7,762.47 | Facility | None | $181.97 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $251.19 | Professional | None | $162.18 | $245.47 | $251.19 |
BCBS New Mexico Setting Facility Modifier None Typical Low $933.25 Median $3,388.44 Typical High $5,128.61 | Facility | None | $933.25 | $3,388.44 | $5,128.61 |
BCBS New Mexico Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $251.19 | Professional | None | $169.82 | $204.17 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,288.25 | Facility | None | $537.03 | $870.96 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $389.05 | Professional | None | $190.55 | $275.42 | $389.05 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $245.47 | Professional | None | $33.11 | $48.98 | $245.47 |
Providence Setting Facility Modifier None Typical Low $234.42 Median $851.14 Typical High $1,318.26 | Facility | None | $234.42 | $851.14 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $389.05 | Professional | None | $194.98 | $275.42 | $389.05 |
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 $186.21 Median $269.15 Typical High $389.05 | Professional | None | $186.21 | $269.15 | $389.05 |
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 $81.28 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $81.28 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $123.03 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $24.55 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $24.55 | $24.55 |
Where New Mexico sits
The same service costs 7.7 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 $4,047MT $526
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.