How much rates vary
Facilitymedian $16,982 · 10th to 90th $513 to $17,378Professionalmedian $1,259 · 10th to 90th $1,000 to $2,042
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 $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
BCBS Alabama Setting Facility Modifier None Typical Low $16,982.44 Median $17,378.01 Typical High $17,378.01 | Facility | None | $16,982.44 | $17,378.01 | $17,378.01 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,071.52 Median $1,479.11 Typical High $1,819.70 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,071.52 | $1,479.11 | $1,819.70 |
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 $1,000.00 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,202.26 | $1,698.24 |
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 $870.96 Median $1,096.48 Typical High $1,621.81 | Professional | None | $870.96 | $1,096.48 | $1,621.81 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 58 · Staged procedure | $1,318.26 | $1,318.26 | $1,318.26 |
Where Alabama sits
The same service costs 9.9 times more in Alabama 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
AL $18,241MD $1,851
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.