How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,122 to $3,715Professionalmedian $776 · 10th to 90th $200 to $1,288
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 $616.60 Median $1,230.27 Typical High $1,905.46 | Facility | None | $616.60 | $1,230.27 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $691.83 Typical High $1,288.25 | Professional | None | $331.13 | $691.83 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,162.28 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,162.28 | $3,235.94 | $3,235.94 |
BCBS Alabama Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,096.48 | Professional | None | $562.34 | $776.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,949.84 Typical High $2,454.71 | Facility | None | $489.78 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $1,047.13 | Professional | None | $181.97 | $309.03 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,128.61 | Facility | None | $1,096.48 | $2,454.71 | $5,128.61 |
United Setting Professional Modifier None Typical Low $162.18 Median $575.44 Typical High $954.99 | Professional | None | $162.18 | $575.44 | $954.99 |
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 $165.96 Median $407.38 Typical High $645.65 | Professional | 52 · Reduced service | $165.96 | $407.38 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $162.18 Typical High $257.04 | Professional | 53 · Discontinued | $66.07 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $602.56 Typical High $954.99 | Professional | 54 · Surgery only | $245.47 | $602.56 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $120.23 Typical High $190.55 | Professional | 55 · Aftercare only | $50.12 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $81.28 Typical High $128.82 | Professional | 56 · Pre-op care only | $33.11 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $562.34 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $229.09 | $562.34 | $891.25 |
Where Alabama sits
The same service costs 5.1 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 $7,315MT $1,443
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.