How much rates vary
Facilitymedian $1,479 · 10th to 90th $575 to $2,291Professionalmedian $871 · 10th to 90th $692 to $1,072
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 $676.08 Median $1,096.48 Typical High $1,905.46 | Facility | None | $676.08 | $1,096.48 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $912.01 | Professional | None | $741.31 | $758.58 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,445.44 | $1,479.11 | $1,479.11 |
BCBS Alabama Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,122.02 | Professional | None | $741.31 | $1,000.00 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,862.09 Typical High $2,290.87 | Facility | None | $489.78 | $1,862.09 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,000.00 | Professional | None | $724.44 | $870.96 | $1,000.00 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,235.94 | Facility | None | $467.74 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,122.02 | Professional | None | $616.60 | $741.31 | $1,122.02 |
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 $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $537.03 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in Georgia. 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
AK $7,038GA $2,000
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.