How much rates vary
Facilitymedian $1,905 · 10th to 90th $832 to $9,120Professionalmedian $646 · 10th to 90th $309 to $1,122
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 $338.84 Median $1,047.13 Typical High $7,762.47 | Facility | None | $338.84 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $851.14 | Professional | None | $338.84 | $524.81 | $851.14 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,905.46 Median $6,760.83 Typical High $10,471.29 | Facility | None | $1,905.46 | $6,760.83 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,148.15 Typical High $1,548.82 | Facility | None | $537.03 | $1,148.15 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $645.65 Typical High $1,071.52 | Professional | None | $380.19 | $645.65 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $758.58 Typical High $1,258.93 | Professional | None | $33.11 | $758.58 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $1,148.15 Typical High $1,584.89 | Facility | None | $309.03 | $1,148.15 | $1,584.89 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $1,096.48 | Professional | None | $380.19 | $724.44 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $363.08 Median $616.60 Typical High $1,122.02 | Professional | None | $363.08 | $616.60 | $1,122.02 |
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 $169.82 Median $263.03 Typical High $426.58 | Professional | 52 · Reduced service | $169.82 | $263.03 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $104.71 Typical High $169.82 | Professional | 53 · Discontinued | $67.61 | $104.71 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $389.05 Typical High $645.65 | Professional | 54 · Surgery only | $251.19 | $389.05 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $79.43 Typical High $128.82 | Professional | 55 · Aftercare only | $50.12 | $79.43 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $52.48 Typical High $85.11 | Professional | 56 · Pre-op care only | $33.88 | $52.48 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $363.08 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $234.42 | $363.08 | $602.56 |
Where New Mexico sits
The same service costs 3.2 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 $4,968MT $1,567
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.