How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,738 to $7,762Professionalmedian $631 · 10th to 90th $457 to $912
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 $1,096.48 Typical High $2,187.76 | Facility | None | $776.25 | $1,096.48 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $912.01 Typical High $912.01 | Professional | None | $537.03 | $912.01 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $467.74 Median $645.65 Typical High $812.83 | Professional | 32 · Mandated service | $467.74 | $645.65 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,570.88 Typical High $5,623.41 | Facility | None | $645.65 | $4,570.88 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $676.08 | Professional | None | $537.03 | $630.96 | $676.08 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $8,511.38 | Facility | None | $1,698.24 | $4,466.84 | $8,511.38 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $891.25 | Professional | None | $426.58 | $537.03 | $891.25 |
6 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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
Where Alabama sits
The same service costs 7.5 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 $13,659MT $1,825
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.