How much rates vary
Facilitymedian $1,445 · 10th to 90th $575 to $7,413Professionalmedian $295 · 10th to 90th $85 to $851
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 $102.33 Median $954.99 Typical High $2,137.96 | Facility | None | $102.33 | $954.99 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $426.58 Typical High $851.14 | Professional | None | $69.18 | $426.58 | $851.14 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,548.82 Median $5,495.41 Typical High $8,511.38 | Facility | None | $1,548.82 | $5,495.41 | $8,511.38 |
BCBS New Mexico Setting Professional Modifier None Typical Low $85.11 Median $398.11 Typical High $660.69 | Professional | None | $85.11 | $398.11 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,445.44 | Facility | None | $602.56 | $1,047.13 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $870.96 | Professional | None | $85.11 | $125.89 | $870.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $467.74 Typical High $776.25 | Professional | None | $33.11 | $467.74 | $776.25 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $851.14 Typical High $1,513.56 | Facility | None | $87.10 | $851.14 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $870.96 | Professional | None | $85.11 | $131.83 | $870.96 |
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 $87.10 Median $436.52 Typical High $933.25 | Professional | None | $87.10 | $436.52 | $933.25 |
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 $36.31 Median $213.80 Typical High $426.58 | Professional | 52 · Reduced service | $36.31 | $213.80 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $85.11 Typical High $169.82 | Professional | 53 · Discontinued | $14.45 | $85.11 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $323.59 Typical High $630.96 | Professional | 54 · Surgery only | $53.70 | $323.59 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $64.57 Typical High $125.89 | Professional | 55 · Aftercare only | $10.72 | $64.57 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $42.66 Typical High $85.11 | Professional | 56 · Pre-op care only | $7.24 | $42.66 | $85.11 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 59 · Distinct service | $60.26 | $60.26 | $60.26 |
Where New Mexico sits
The same service costs 5.6 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 $4,728MT $843
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.