How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,122 to $4,571Professionalmedian $794 · 10th to 90th $550 to $1,072
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 $1,122.02 Typical High $1,905.46 | Facility | None | $645.65 | $1,122.02 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,071.52 | Professional | None | $645.65 | $1,071.52 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $645.65 Median $870.96 Typical High $1,071.52 | Professional | 32 · Mandated service | $645.65 | $870.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,548.82 Typical High $1,949.84 | Facility | None | $489.78 | $1,548.82 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $870.96 | Professional | None | $676.08 | $794.33 | $870.96 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,096.48 | $2,454.71 | $5,248.07 |
United Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,096.48 | Professional | None | $512.86 | $645.65 | $1,096.48 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $6,760.83 Median $6,918.31 Typical High $6,918.31 | Facility | 50 · Both sides | $6,760.83 | $6,918.31 | $6,918.31 |
Where Alabama sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.