How much rates vary
Facilitymedian $275 · 10th to 90th $107 to $1,023Professionalmedian $91 · 10th to 90th $56 to $135
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 $56.23 Median $107.15 Typical High $1,737.80 | Facility | None | $56.23 | $107.15 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $123.03 | Professional | None | $56.23 | $97.72 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $95.50 Typical High $95.50 | Professional | None | $48.98 | $95.50 | $95.50 |
BCBS Alabama Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $275.42 | Facility | None | $269.15 | $275.42 | $275.42 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $67.61 Median $79.43 Typical High $97.72 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $67.61 | $79.43 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $104.71 | Professional | None | $56.23 | $81.28 | $104.71 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $151.36 | Professional | None | $50.12 | $91.20 | $151.36 |
5 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 $28.18 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $28.18 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $17.38 Typical High $21.38 | Professional | 53 · Discontinued | $11.22 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $66.07 Typical High $79.43 | Professional | 54 · Surgery only | $41.69 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $8.32 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.71 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.62 | $8.71 | $10.72 |
Where Alabama sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.