How much rates vary
Facilitymedian $2,089 · 10th to 90th $646 to $9,120Professionalmedian $550 · 10th to 90th $309 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 $389.05 Median $1,548.82 Typical High $8,709.64 | Facility | None | $389.05 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $549.54 | Professional | None | $363.08 | $549.54 | $549.54 |
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 |
BCBS New Mexico Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $1,122.02 | Professional | None | $436.52 | $501.19 | $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 $389.05 Median $457.09 Typical High $676.08 | Professional | None | $389.05 | $457.09 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $117.49 Typical High $588.84 | Professional | None | $33.11 | $117.49 | $588.84 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $2,238.72 | Facility | None | $512.86 | $1,230.27 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $724.44 | Professional | None | $389.05 | $457.09 | $724.44 |
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 $354.81 Median $549.54 Typical High $724.44 | Professional | None | $354.81 | $549.54 | $724.44 |
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 $181.97 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $181.97 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $72.44 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $275.42 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $54.95 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $36.31 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $257.04 | $380.19 | $380.19 |
Where New Mexico sits
The same service costs 4.0 times more in Oklahoma 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
OK $5,265MT $1,322
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.