How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,862 to $7,762Professionalmedian $1,047 · 10th to 90th $741 to $1,479
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 $933.25 Median $1,445.44 Typical High $1,445.44 | Professional | None | $933.25 | $1,445.44 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $512.86 | Professional | None | $69.18 | $69.18 | $512.86 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,174.90 Median $1,479.11 Typical High $1,584.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,174.90 | $1,479.11 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $8,511.38 Typical High $10,471.29 | Facility | None | $645.65 | $8,511.38 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,621.81 | Professional | None | $891.25 | $1,047.13 | $1,621.81 |
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 $691.83 Median $870.96 Typical High $1,412.54 | Professional | None | $691.83 | $870.96 | $1,412.54 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,023.29 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $11,481.54 Median $11,748.98 Typical High $11,748.98 | Facility | 50 · Both sides | $11,481.54 | $11,748.98 | $11,748.98 |
Where Alabama sits
The same service costs 6.8 times more in Alaska 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
AK $19,480MT $2,858
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.