How much rates vary
Facilitymedian $2,818 · 10th to 90th $871 to $2,884Professionalmedian $692 · 10th to 90th $575 to $813
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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $794.33 | Professional | None | $645.65 | $691.83 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,818.38 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,071.52 Typical High $1,318.26 | Facility | None | $549.54 | $1,071.52 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $776.25 | Professional | None | $575.44 | $630.96 | $776.25 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,073.80 | Facility | None | $758.58 | $1,737.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,047.13 | Professional | None | $562.34 | $691.83 | $1,047.13 |
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 $316.23 Median $354.81 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $549.54 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $389.05 Median $537.03 Typical High $891.25 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $389.05 | $537.03 | $891.25 |
Where Alabama sits
The same service costs 3.1 times more in Alaska than in Maryland. 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 $5,990MD $1,938
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.