How much rates vary
Facilitymedian $10,000 · 10th to 90th $537 to $31,623Professionalmedian $363 · 10th to 90th $182 to $3,802
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 $2,089.30 Typical High $7,762.47 | Facility | None | $371.54 | $2,089.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $512.86 Typical High $3,235.94 | Professional | None | $245.47 | $512.86 | $3,235.94 |
BCBS New Mexico Setting Facility Modifier None Typical Low $6,606.93 Median $23,988.33 Typical High $36,307.81 | Facility | None | $6,606.93 | $23,988.33 | $36,307.81 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $10,000.00 Typical High $14,125.38 | Facility | None | $537.03 | $10,000.00 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $3,162.28 | Professional | None | $181.97 | $251.19 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $3,162.28 Typical High $5,248.07 | Professional | None | $33.11 | $3,162.28 | $5,248.07 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $1,288.25 Typical High $14,454.40 | Facility | None | $165.96 | $1,288.25 | $14,454.40 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $3,801.89 | Professional | None | $181.97 | $269.15 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $21,877.62 | Facility | None | $1,995.26 | $5,495.41 | $21,877.62 |
United Setting Professional Modifier None Typical Low $181.97 Median $354.81 Typical High $3,162.28 | Professional | None | $181.97 | $354.81 | $3,162.28 |
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 $123.03 Median $257.04 Typical High $1,621.81 | Professional | 52 · Reduced service | $123.03 | $257.04 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $102.33 Typical High $660.69 | Professional | 53 · Discontinued | $48.98 | $102.33 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $380.19 Typical High $2,454.71 | Professional | 54 · Surgery only | $186.21 | $380.19 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $75.86 Typical High $489.78 | Professional | 55 · Aftercare only | $37.15 | $75.86 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $51.29 Typical High $323.59 | Professional | 56 · Pre-op care only | $24.55 | $51.29 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $354.81 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $173.78 | $354.81 | $2,290.87 |
Where New Mexico sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.