How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,862 to $6,026Professionalmedian $646 · 10th to 90th $490 to $1,148
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 $954.99 Median $1,513.56 Typical High $2,398.83 | Facility | None | $954.99 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,148.15 Typical High $1,148.15 | Professional | None | $676.08 | $1,148.15 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $6,025.60 | Facility | None | $5,888.44 | $6,025.60 | $6,025.60 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $758.58 Median $870.96 Typical High $1,122.02 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $758.58 | $870.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $3,019.95 Typical High $4,265.80 | Facility | None | $1,380.38 | $3,019.95 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,122.02 | Professional | None | $562.34 | $616.60 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,317.64 | Facility | None | $1,698.24 | $3,801.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,023.29 | Professional | None | $446.68 | $562.34 | $1,023.29 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Alabama sits
The same service costs 5.8 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 $11,009MT $1,889
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.