How much rates vary
Facilitymedian $646 · 10th to 90th $158 to $977Professionalmedian $562 · 10th to 90th $398 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 $489.78 Median $812.83 Typical High $1,862.09 | Facility | None | $489.78 | $812.83 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | None | $758.58 | $758.58 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
BCBS Alabama Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $501.19 | Facility | None | $128.82 | $158.49 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $660.69 | Professional | None | $457.09 | $537.03 | $660.69 |
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 $363.08 Median $446.68 Typical High $724.44 | Professional | None | $363.08 | $446.68 | $724.44 |
8 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 $371.54 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $562.34 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $562.34 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | 50 · Both sides | $977.24 | $977.24 | $977.24 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $407.38 Median $562.34 Typical High $707.95 | Professional | 32 · Mandated service | $407.38 | $562.34 | $707.95 |
Where Alabama sits
The same service costs 4.7 times more in New York than in Florida. 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
NY $3,038FL $649
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.