How much rates vary
Facilitymedian $1,445 · 10th to 90th $724 to $4,467Professionalmedian $380 · 10th to 90th $209 to $692
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 $281.84 Median $630.96 Typical High $2,137.96 | Facility | None | $281.84 | $630.96 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $575.44 | Professional | None | $234.42 | $281.84 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $354.81 Typical High $446.68 | Professional | None | $169.82 | $354.81 | $446.68 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,023.29 | $1,949.84 | $4,265.80 |
BCBS New Mexico Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $524.81 | Professional | None | $229.09 | $389.05 | $524.81 |
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 $245.47 Median $380.19 Typical High $691.83 | Professional | None | $245.47 | $380.19 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $363.08 Typical High $602.56 | Professional | None | $33.11 | $363.08 | $602.56 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,230.27 Typical High $1,584.89 | Facility | None | $537.03 | $1,230.27 | $1,584.89 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $691.83 | Professional | None | $257.04 | $389.05 | $691.83 |
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 $251.19 Median $436.52 Typical High $758.58 | Professional | None | $251.19 | $436.52 | $758.58 |
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 $93.33 Median $177.83 Typical High $288.40 | Professional | 52 · Reduced service | $93.33 | $177.83 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $70.79 Typical High $114.82 | Professional | 53 · Discontinued | $37.15 | $70.79 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $263.03 Typical High $436.52 | Professional | 54 · Surgery only | $141.25 | $263.03 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $52.48 Typical High $87.10 | Professional | 55 · Aftercare only | $28.18 | $52.48 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $35.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $18.62 | $35.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $245.47 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $131.83 | $245.47 | $407.38 |
Where New Mexico sits
The same service costs 4.6 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 $4,728MT $1,029
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.