How much rates vary
Facilitymedian $10,233 · 10th to 90th $1,905 to $10,233Professionalmedian $1,230 · 10th to 90th $891 to $1,738
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 $1,513.56 Typical High $2,398.83 | Facility | None | $794.33 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,000.00 Median $1,348.96 Typical High $1,698.24 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,000.00 | $1,348.96 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $9,120.11 Typical High $11,220.18 | Facility | None | $549.54 | $9,120.11 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,230.27 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,709.64 | Facility | None | $1,698.24 | $3,801.89 | $8,709.64 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,698.24 | Professional | None | $831.76 | $1,047.13 | $1,698.24 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
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 6.0 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 $15,585KY $2,601
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.