How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,072 to $7,413Professionalmedian $1,549 · 10th to 90th $1,202 to $2,754
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 $1,659.59 Typical High $2,630.27 | Facility | None | $954.99 | $1,659.59 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,513.56 | $2,754.23 | $2,754.23 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,380.38 | $1,862.09 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,244.36 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,244.36 | $7,413.10 | $7,413.10 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,513.56 Median $2,041.74 Typical High $2,290.87 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,513.56 | $2,041.74 | $2,290.87 |
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 $1,412.54 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,513.56 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,691.53 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,691.53 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,348.96 | $2,511.89 |
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $1,949.84 |
Where Alabama sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.