How much rates vary
Facilitymedian $813 · 10th to 90th $331 to $2,089Professionalmedian $174 · 10th to 90th $100 to $263
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 $109.65 Median $1,047.13 Typical High $7,762.47 | Facility | None | $109.65 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $223.87 | Professional | None | $109.65 | $151.36 | $223.87 |
BCBS New Mexico Setting Facility Modifier None Typical Low $380.19 Median $1,348.96 Typical High $2,089.30 | Facility | None | $380.19 | $1,348.96 | $2,089.30 |
BCBS New Mexico Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $199.53 | Professional | None | $97.72 | $162.18 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $1,202.26 | Facility | None | $446.68 | $537.03 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $263.03 | Professional | None | $125.89 | $177.83 | $263.03 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $141.25 Typical High $239.88 | Professional | None | $28.18 | $141.25 | $239.88 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $524.81 Typical High $1,288.25 | Facility | None | $158.49 | $524.81 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $275.42 | Professional | None | $125.89 | $177.83 | $275.42 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $2,630.27 | Facility | None | $346.74 | $707.95 | $2,630.27 |
United Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $295.12 | Professional | None | $123.03 | $186.21 | $295.12 |
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 $54.95 Median $75.86 Typical High $112.20 | Professional | 52 · Reduced service | $54.95 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $21.88 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $83.18 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $33.88 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.14 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.96 | $15.14 | $22.39 |
Where New Mexico sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.