How much rates vary
Facilitymedian $2,570 · 10th to 90th $871 to $3,162Professionalmedian $339 · 10th to 90th $257 to $468
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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $407.38 | Professional | None | $275.42 | $354.81 | $407.38 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $1,479.11 | Facility | None | $489.78 | $1,174.90 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $489.78 | Professional | None | $251.19 | $309.03 | $489.78 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $501.19 | Professional | None | $245.47 | $323.59 | $501.19 |
7 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 $138.04 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $67.61 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $251.19 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $234.42 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $194.98 | $234.42 | $269.15 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $295.12 Median $389.05 Typical High $426.58 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $295.12 | $389.05 | $426.58 |
Where Alabama sits
The same service costs 6.1 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 $6,346MT $1,043
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.