How much rates vary
Facilitymedian $646 · 10th to 90th $141 to $977Professionalmedian $363 · 10th to 90th $234 to $537
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 $457.09 Median $1,096.48 Typical High $2,398.83 | Facility | None | $457.09 | $1,096.48 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $537.03 | Professional | None | $316.23 | $457.09 | $537.03 |
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 $50.12 Median $134.90 Typical High $446.68 | Facility | None | $50.12 | $134.90 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $398.11 | Professional | None | $263.03 | $316.23 | $398.11 |
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 $223.87 Median $281.84 Typical High $467.74 | Professional | None | $223.87 | $281.84 | $467.74 |
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 $229.09 Median $229.09 Typical High $269.15 | Professional | 52 · Reduced service | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $371.54 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $223.87 Median $309.03 Typical High $426.58 | Professional | 32 · Mandated service | $223.87 | $309.03 | $426.58 |
Where Alabama sits
The same service costs 6.7 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 $2,828FL $419
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.