How much rates vary
Facilitymedian $2,951 · 10th to 90th $676 to $14,791Professionalmedian $1,349 · 10th to 90th $871 to $1,820
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 $1,000.00 Median $1,380.38 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,445.44 | Professional | None | $933.25 | $1,445.44 | $1,445.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $3,388.44 Typical High $18,197.01 | Facility | None | $537.03 | $3,388.44 | $18,197.01 |
BCBS New Mexico Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,949.84 | Professional | None | $954.99 | $1,288.25 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,511.89 Typical High $3,548.13 | Facility | None | $776.25 | $2,511.89 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,230.27 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $302.00 Typical High $1,513.56 | Professional | None | $33.11 | $302.00 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,513.56 Typical High $3,630.78 | Facility | None | $776.25 | $1,513.56 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,230.27 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $1,905.46 | Professional | None | $954.99 | $1,479.11 | $1,905.46 |
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 $478.63 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $478.63 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $194.98 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $724.44 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $144.54 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $676.08 | $1,000.00 | $1,000.00 |
Where New Mexico sits
The same service costs 5.3 times more in Vermont than in Hawaii. 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
VT $13,652HI $2,577
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.