How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,698 to $5,623Professionalmedian $776 · 10th to 90th $550 to $1,023
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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,023.29 | Professional | None | $724.44 | $1,023.29 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,258.93 | Professional | None | $602.56 | $602.56 | $1,258.93 |
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 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $630.96 Median $870.96 Typical High $1,071.52 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $630.96 | $870.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,621.81 Typical High $2,290.87 | Facility | None | $512.86 | $1,621.81 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $891.25 | Professional | None | $660.69 | $776.25 | $891.25 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $7,413.10 | Facility | None | $1,513.56 | $3,801.89 | $7,413.10 |
United Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,047.13 | Professional | None | $512.86 | $630.96 | $1,047.13 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
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 7.6 times more in Oklahoma than in Texas. 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
OK $11,248TX $1,472
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.