How much rates vary
Facilitymedian $1,380 · 10th to 90th $562 to $1,950Professionalmedian $263 · 10th to 90th $126 to $741
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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $741.31 | Professional | None | $263.03 | $323.59 | $741.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $134.90 Typical High $371.54 | Professional | 52 · Reduced service | $131.83 | $134.90 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $147.91 | Professional | 53 · Discontinued | $52.48 | $53.70 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $549.54 | Professional | 54 · Surgery only | $194.98 | $204.17 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $109.65 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.92 Typical High $74.13 | Professional | 56 · Pre-op care only | $26.30 | $26.92 | $74.13 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,380.38 | $1,412.54 | $1,412.54 |
BCBS Alabama Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $1,047.13 | Facility | None | $363.08 | $851.14 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $407.38 | Professional | None | $154.88 | $190.55 | $407.38 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $389.05 | Professional | None | $107.15 | $218.78 | $389.05 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $269.15 Median $363.08 Typical High $512.86 | Professional | 32 · Mandated service | $269.15 | $363.08 | $512.86 |
Where Alabama sits
The same service costs 5.7 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 $4,090MT $722
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.