How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,413 to $6,607Professionalmedian $1,514 · 10th to 90th $1,072 to $2,089
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 $891.25 Median $1,348.96 Typical High $2,398.83 | Facility | None | $891.25 | $1,348.96 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,288.25 | $2,089.30 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,456.54 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,456.54 | $6,606.93 | $6,606.93 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,202.26 Median $1,621.81 Typical High $2,041.74 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,202.26 | $1,621.81 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,548.13 Typical High $4,365.16 | Facility | None | $741.31 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,513.56 | $1,659.59 |
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 $1,000.00 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,230.27 | $2,041.74 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,445.44 |
Where Alabama sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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 $14,661HI $3,664
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.