How much rates vary
Facilitymedian $1,622 · 10th to 90th $794 to $4,169Professionalmedian $589 · 10th to 90th $427 to $794
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 $489.78 Median $1,230.27 Typical High $2,041.74 | Facility | None | $489.78 | $1,230.27 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $676.08 | Professional | None | $398.11 | $489.78 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,019.95 Typical High $4,168.69 | Facility | None | $1,513.56 | $3,019.95 | $4,168.69 |
BCBS Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $794.33 | Professional | None | $436.52 | $575.44 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,412.54 Typical High $1,862.09 | Facility | None | $562.34 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $933.25 | Professional | None | $416.87 | $660.69 | $933.25 |
Qualchoice Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $912.01 | Professional | None | $371.54 | $549.54 | $912.01 |
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 $239.88 Median $251.19 Typical High $338.84 | Professional | 52 · Reduced service | $239.88 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $138.04 | Professional | 53 · Discontinued | $97.72 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $512.86 | Professional | 54 · Surgery only | $363.08 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $102.33 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $67.61 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $478.63 |
Where Arkansas sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.