How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,660 to $7,762Professionalmedian $676 · 10th to 90th $479 to $933
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 $794.33 Median $1,258.93 Typical High $2,398.83 | Facility | None | $794.33 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $933.25 | Professional | None | $575.44 | $933.25 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $436.52 Median $602.56 Typical High $776.25 | Professional | 32 · Mandated service | $436.52 | $602.56 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,621.81 Typical High $1,949.84 | Facility | None | $645.65 | $1,621.81 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $691.83 | Professional | None | $575.44 | $676.08 | $691.83 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $7,762.47 | Facility | None | $1,698.24 | $3,801.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $870.96 | Professional | None | $426.58 | $549.54 | $870.96 |
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 $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Alabama sits
The same service costs 4.7 times more in Oklahoma than in Montana. 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
OK $8,820MT $1,888
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.