How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $15,488Professionalmedian $813 · 10th to 90th $178 to $1,000
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 $645.65 Median $2,089.30 Typical High $8,709.64 | Facility | None | $645.65 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | None | $575.44 | $912.01 | $912.01 |
BCBS New Mexico Setting Facility Modifier None Typical Low $3,235.94 Median $11,481.54 Typical High $17,782.79 | Facility | None | $3,235.94 | $11,481.54 | $17,782.79 |
BCBS New Mexico Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,023.29 | Professional | None | $537.03 | $741.31 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,548.13 | Facility | None | $741.31 | $2,187.76 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $977.24 | Professional | None | $616.60 | $741.31 | $977.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $177.83 Typical High $891.25 | Professional | None | $33.11 | $177.83 | $891.25 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $2,187.76 Typical High $3,548.13 | Facility | None | $562.34 | $2,187.76 | $3,548.13 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,023.29 | Professional | None | $645.65 | $758.58 | $1,023.29 |
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 $851.14 Typical High $1,174.90 | Professional | None | $602.56 | $851.14 | $1,174.90 |
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 $288.40 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $288.40 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $114.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $436.52 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $87.10 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $57.54 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $407.38 | $630.96 | $630.96 |
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 $7,787MT $1,955
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.