How much rates vary
Facilitymedian $1,738 · 10th to 90th $525 to $2,042Professionalmedian $141 · 10th to 90th $78 to $263
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 $117.49 Median $575.44 Typical High $1,862.09 | Facility | None | $117.49 | $575.44 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $263.03 | Professional | None | $117.49 | $158.49 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $158.49 | Professional | None | $81.28 | $158.49 | $158.49 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $56.23 Median $77.62 Typical High $112.20 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $56.23 | $77.62 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,202.26 Typical High $1,737.80 | Facility | None | $501.19 | $1,202.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $234.42 | Professional | None | $87.10 | $151.36 | $234.42 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $3,235.94 | Facility | None | $478.63 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $66.07 Median $134.90 Typical High $245.47 | Professional | None | $66.07 | $134.90 | $245.47 |
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 $58.88 Median $69.18 Typical High $131.83 | Professional | 52 · Reduced service | $58.88 | $69.18 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $27.54 Typical High $52.48 | Professional | 53 · Discontinued | $23.44 | $27.54 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $104.71 Typical High $199.53 | Professional | 54 · Surgery only | $87.10 | $104.71 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.89 Typical High $39.81 | Professional | 55 · Aftercare only | $17.38 | $20.89 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.80 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.75 | $13.80 | $26.30 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Facility | 50 · Both sides | $2,570.40 | $2,630.27 | $2,630.27 |
Where Alabama sits
The same service costs 9.7 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 $4,351MT $447
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.