How much rates vary
Facilitymedian $10,233 · 10th to 90th $1,479 to $10,233Professionalmedian $891 · 10th to 90th $617 to $1,202
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 $794.33 Median $1,258.93 Typical High $2,398.83 | Facility | None | $794.33 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,202.26 | Professional | None | $724.44 | $1,202.26 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $870.96 | Professional | None | $117.49 | $117.49 | $870.96 |
BCBS Alabama Setting Facility Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Facility | None | $10,232.93 | $10,232.93 | $10,232.93 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | 32 · Mandated service | $912.01 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,548.13 Typical High $4,365.16 | Facility | None | $645.65 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,000.00 | Professional | None | $758.58 | $891.25 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,288.25 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,202.26 | Professional | None | $575.44 | $724.44 | $1,202.26 |
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 $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $15,135.61 Median $15,488.17 Typical High $15,488.17 | Facility | 50 · Both sides | $15,135.61 | $15,488.17 | $15,488.17 |
Where Alabama sits
The same service costs 5.7 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 $13,613MT $2,377
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.