How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,479 to $6,457Professionalmedian $933 · 10th to 90th $661 to $1,288
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 $954.99 Median $1,778.28 Typical High $2,630.27 | Facility | None | $954.99 | $1,778.28 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $891.25 | $1,288.25 | $1,288.25 |
BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,047.13 Median $1,318.26 Typical High $1,513.56 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,047.13 | $1,318.26 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,884.03 Typical High $3,548.13 | Facility | None | $1,023.29 | $2,884.03 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,621.81 | Professional | None | $794.33 | $933.25 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,288.25 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,230.27 | Professional | None | $616.60 | $776.25 | $1,230.27 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Facility | 50 · Both sides | $9,772.37 | $9,772.37 | $9,772.37 |
Where Alabama sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $10,315KY $2,095
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.