How much rates vary
Facilitymedian $8,128 · 10th to 90th $1,738 to $8,128Professionalmedian $1,259 · 10th to 90th $891 to $1,738
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 $891.25 Median $1,659.59 Typical High $2,398.83 | Facility | None | $891.25 | $1,659.59 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,737.80 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $891.25 Typical High $1,202.26 | Professional | None | $162.18 | $891.25 | $1,202.26 |
BCBS Alabama Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,230.27 Median $1,659.59 Typical High $1,778.28 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,230.27 | $1,659.59 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,258.93 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,981.07 Typical High $8,511.38 | Facility | None | $1,698.24 | $3,981.07 | $8,511.38 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,737.80 | Professional | None | $831.76 | $1,023.29 | $1,737.80 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 80 · Assistant surgeon | $141.25 | $141.25 | $141.25 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | 50 · Both sides | $12,302.69 | $12,302.69 | $12,302.69 |
Where Alabama sits
The same service costs 4.2 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 $14,362MT $3,396
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.