How much rates vary
Facilitymedian $2,512 · 10th to 90th $871 to $3,162Professionalmedian $617 · 10th to 90th $363 to $832
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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $831.76 | Professional | None | $467.74 | $630.96 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,511.89 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $1,479.11 | Facility | None | $489.78 | $1,174.90 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $776.25 | Professional | None | $446.68 | $588.84 | $776.25 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $758.58 | Professional | None | $316.23 | $446.68 | $758.58 |
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 $316.23 Median $316.23 Typical High $407.38 | Professional | 52 · Reduced service | $316.23 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $575.44 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | 50 · Both sides | $3,801.89 | $3,801.89 | $3,801.89 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $524.81 Median $645.65 Typical High $776.25 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $524.81 | $645.65 | $776.25 |
Where Alabama sits
The same service costs 4.7 times more in Colorado 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
CO $6,464MT $1,390
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.