How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,738 to $5,754Professionalmedian $2,455 · 10th to 90th $1,622 to $3,311
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 $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,698.24 Median $2,344.23 Typical High $2,884.03 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,698.24 | $2,344.23 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $4,365.16 | Facility | None | $512.86 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,454.71 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,513.56 | $3,801.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,819.70 | $3,019.95 |
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,290.87 | $2,290.87 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $7,585.78 Typical High $7,585.78 | Facility | 50 · Both sides | $7,413.10 | $7,585.78 | $7,585.78 |
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 $18,090KY $3,723
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.