How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,698 to $7,762Professionalmedian $977 · 10th to 90th $724 to $1,445
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 $851.14 Median $1,412.54 Typical High $1,412.54 | Professional | None | $851.14 | $1,412.54 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 32 · Mandated service Typical Low $1,148.15 Median $1,445.44 Typical High $1,698.24 | Professional | 32 · Mandated service | $1,148.15 | $1,445.44 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,570.88 Typical High $5,754.40 | Facility | None | $549.54 | $4,570.88 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,698.24 | Professional | None | $831.76 | $977.24 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,698.24 | $3,801.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,380.38 | Professional | None | $676.08 | $831.76 | $1,380.38 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $977.24 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 80 · Assistant surgeon | $120.23 | $120.23 | $120.23 |
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 5.5 times more in Colorado 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
CO $14,085HI $2,567
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.