How much rates vary
Facilitymedian $3,236 · 10th to 90th $794 to $13,183Professionalmedian $794 · 10th to 90th $174 to $977
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 $630.96 Median $2,041.74 Typical High $7,762.47 | Facility | None | $630.96 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $870.96 | Professional | None | $562.34 | $870.96 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,754.23 Median $9,772.37 Typical High $15,135.61 | Facility | None | $2,754.23 | $9,772.37 | $15,135.61 |
BCBS New Mexico Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $977.24 | Professional | None | $501.19 | $724.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,041.74 Typical High $3,548.13 | Facility | None | $776.25 | $2,041.74 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $954.99 | Professional | None | $602.56 | $724.44 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $870.96 | Professional | None | $33.11 | $173.78 | $870.96 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,041.74 Typical High $3,548.13 | Facility | None | $537.03 | $2,041.74 | $3,548.13 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,000.00 | Professional | None | $630.96 | $741.31 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,235.94 | $10,471.29 |
United Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,148.15 | Professional | None | $602.56 | $831.76 | $1,148.15 |
6 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 $281.84 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $281.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $112.20 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $426.58 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $85.11 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $56.23 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $398.11 | $616.60 | $616.60 |
Where New Mexico sits
The same service costs 4.0 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 $7,771MT $1,932
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.