How much rates vary
Facilitymedian $1,514 · 10th to 90th $631 to $7,586Professionalmedian $661 · 10th to 90th $363 to $955
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 $489.78 Median $1,380.38 Typical High $7,762.47 | Facility | None | $489.78 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $912.01 | Professional | None | $489.78 | $724.44 | $912.01 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $1,698.24 Typical High $8,912.51 | Facility | None | $537.03 | $1,698.24 | $8,912.51 |
BCBS New Mexico Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $812.83 | Professional | None | $309.03 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,778.28 | Facility | None | $776.25 | $1,318.26 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $977.24 | Professional | None | $407.38 | $660.69 | $977.24 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $489.78 Typical High $1,230.27 | Professional | None | $97.72 | $489.78 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $1,318.26 Typical High $1,949.84 | Facility | None | $426.58 | $1,318.26 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $954.99 | Professional | None | $426.58 | $660.69 | $954.99 |
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 $467.74 Median $676.08 Typical High $977.24 | Professional | None | $467.74 | $676.08 | $977.24 |
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 $239.88 Median $363.08 Typical High $457.09 | Professional | 52 · Reduced service | $239.88 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $144.54 Typical High $186.21 | Professional | 53 · Discontinued | $97.72 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $549.54 Typical High $691.83 | Professional | 54 · Surgery only | $363.08 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $109.65 Typical High $138.04 | Professional | 55 · Aftercare only | $72.44 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $48.98 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $512.86 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $338.84 | $512.86 | $645.65 |
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 $4,996MT $1,537
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.