How much rates vary
Facilitymedian $1,514 · 10th to 90th $692 to $7,762Professionalmedian $871 · 10th to 90th $646 to $1,259
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 $707.95 Median $1,548.82 Typical High $8,709.64 | Facility | None | $707.95 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | None | $645.65 | $977.24 | $977.24 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $1,513.56 Typical High $9,120.11 | Facility | None | $616.60 | $1,513.56 | $9,120.11 |
BCBS New Mexico Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,122.02 | Professional | None | $645.65 | $870.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,288.25 Typical High $1,905.46 | Facility | None | $602.56 | $1,288.25 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,258.93 | Professional | None | $724.44 | $851.14 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $208.93 Typical High $1,047.13 | Professional | None | $33.11 | $208.93 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $2,238.72 | Facility | None | $602.56 | $1,230.27 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,348.96 | Professional | None | $724.44 | $851.14 | $1,348.96 |
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 $645.65 Median $1,023.29 Typical High $1,318.26 | Professional | None | $645.65 | $1,023.29 | $1,318.26 |
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 $331.13 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $331.13 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $134.90 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $501.19 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $100.00 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $66.07 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $467.74 | $691.83 | $691.83 |
Where New Mexico sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.