How much rates vary
Facilitymedian $1,514 · 10th to 90th $479 to $7,586Professionalmedian $288 · 10th to 90th $170 to $525
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 $190.55 Median $1,380.38 Typical High $7,762.47 | Facility | None | $190.55 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $524.81 | Professional | None | $190.55 | $288.40 | $524.81 |
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 $169.82 Median $281.84 Typical High $407.38 | Professional | None | $169.82 | $281.84 | $407.38 |
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 $199.53 Median $302.00 Typical High $501.19 | Professional | None | $199.53 | $302.00 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $91.20 Typical High $457.09 | Professional | None | $33.11 | $91.20 | $457.09 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $1,318.26 Typical High $1,949.84 | Facility | None | $251.19 | $1,318.26 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $501.19 | Professional | None | $199.53 | $302.00 | $501.19 |
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 $186.21 Median $309.03 Typical High $524.81 | Professional | None | $186.21 | $309.03 | $524.81 |
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 $95.50 Median $144.54 Typical High $263.03 | Professional | 52 · Reduced service | $95.50 | $144.54 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $57.54 Typical High $104.71 | Professional | 53 · Discontinued | $38.02 | $57.54 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $213.80 Typical High $389.05 | Professional | 54 · Surgery only | $144.54 | $213.80 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $42.66 Typical High $77.62 | Professional | 55 · Aftercare only | $28.84 | $42.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.84 Typical High $52.48 | Professional | 56 · Pre-op care only | $19.05 | $28.84 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $199.53 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $134.90 | $199.53 | $363.08 |
Where New Mexico sits
The same service costs 6.3 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 $4,654MT $736
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.