How much rates vary
Facilitymedian $18,621 · 10th to 90th $676 to $77,625Professionalmedian $513 · 10th to 90th $324 to $724
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 $371.54 Median $1,380.38 Typical High $7,762.47 | Facility | None | $371.54 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $524.81 | Professional | None | $346.74 | $524.81 | $524.81 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $19,952.62 Typical High $95,499.26 | Facility | None | $537.03 | $19,952.62 | $95,499.26 |
BCBS New Mexico Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $954.99 | Professional | None | $371.54 | $467.74 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $17,782.79 Typical High $25,118.86 | Facility | None | $776.25 | $17,782.79 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $676.08 | Professional | None | $398.11 | $478.63 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $112.20 Typical High $562.34 | Professional | None | $33.11 | $112.20 | $562.34 |
Providence Setting Facility Modifier None Typical Low $489.78 Median $1,513.56 Typical High $25,703.96 | Facility | None | $489.78 | $1,513.56 | $25,703.96 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $724.44 | Professional | None | $398.11 | $478.63 | $724.44 |
United Setting Facility Modifier None Typical Low $6,309.57 Median $16,595.87 Typical High $36,307.81 | Facility | None | $6,309.57 | $16,595.87 | $36,307.81 |
United Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $776.25 | Professional | None | $371.54 | $562.34 | $776.25 |
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 $186.21 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $186.21 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $74.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $275.42 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $54.95 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $37.15 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $257.04 | $363.08 | $363.08 |
Where New Mexico sits
The same service costs 29.4 times more in Alaska 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
AK $37,066MT $1,262
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.