How much rates vary
Facilitymedian $7,762 · 10th to 90th $550 to $26,303Professionalmedian $2,042 · 10th to 90th $1,349 to $2,692
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 $954.99 Median $1,584.89 Typical High $2,570.40 | Facility | None | $954.99 | $1,584.89 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,584.89 | $2,691.53 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
BCBS Alabama Setting Facility Modifier None Typical Low $25,703.96 Median $26,302.68 Typical High $26,302.68 | Facility | None | $25,703.96 | $26,302.68 | $26,302.68 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,230.27 Median $1,698.24 Typical High $2,137.96 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,230.27 | $1,698.24 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,548.82 | $2,041.74 | $2,570.40 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,659.59 | $2,238.72 |
5 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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $269.15 |
Where Alabama sits
The same service costs 24.1 times more in Maine than in Maryland. 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
ME $53,525MD $2,222
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.