How much rates vary
Facilitymedian $8,128 · 10th to 90th $1,738 to $8,128Professionalmedian $676 · 10th to 90th $490 to $891
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 $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 None Typical Low $501.19 Median $676.08 Typical High $851.14 | Professional | None | $501.19 | $676.08 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,388.44 Typical High $4,365.16 | Facility | None | $549.54 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $691.83 | Professional | None | $537.03 | $645.65 | $691.83 |
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 $426.58 Median $524.81 Typical High $870.96 | Professional | None | $426.58 | $524.81 | $870.96 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
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 7.9 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 $13,941MT $1,762
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.