How much rates vary
Facilitymedian $7,762 · 10th to 90th $550 to $16,596Professionalmedian $1,479 · 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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,737.80 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
BCBS Alabama Setting Facility Modifier None Typical Low $16,218.10 Median $16,595.87 Typical High $16,595.87 | Facility | None | $16,218.10 | $16,595.87 | $16,595.87 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $24,547.09 Median $24,547.09 Typical High $24,547.09 | Facility | 50 · Both sides | $24,547.09 | $24,547.09 | $24,547.09 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,096.48 Median $1,445.44 Typical High $1,659.59 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,096.48 | $1,445.44 | $1,659.59 |
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 $1,230.27 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,479.11 | $1,737.80 |
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 $794.33 Median $1,096.48 Typical High $1,479.11 | Professional | None | $794.33 | $1,096.48 | $1,479.11 |
4 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 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 |
Where Alabama sits
The same service costs 9.4 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 $15,900MD $1,684
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.