How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,738 to $7,413Professionalmedian $1,349 · 10th to 90th $955 to $1,862
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 $954.99 Median $1,584.89 Typical High $2,570.40 | Facility | None | $954.99 | $1,584.89 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,819.70 | $1,819.70 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,011.87 | $5,128.61 | $5,128.61 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,479.11 Median $1,862.09 Typical High $1,995.26 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,479.11 | $1,862.09 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $8,317.64 Typical High $12,022.64 | Facility | None | $562.34 | $8,317.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,348.96 | $2,344.23 |
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 $891.25 Median $1,096.48 Typical High $1,819.70 | Professional | None | $891.25 | $1,096.48 | $1,819.70 |
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 $912.01 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | 50 · Both sides | $7,585.78 | $7,585.78 | $7,585.78 |
Where Alabama sits
The same service costs 10.4 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 $29,118KY $2,808
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.