How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,349 to $7,413Professionalmedian $275 · 10th to 90th $214 to $479
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 $478.63 Median $1,258.93 Typical High $2,398.83 | Facility | None | $478.63 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $234.42 Median $316.23 Typical High $398.11 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $234.42 | $316.23 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $2,511.89 | Facility | None | $478.63 | $630.96 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $338.84 | Professional | None | $257.04 | $269.15 | $338.84 |
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 $186.21 Median $234.42 Typical High $436.52 | Professional | None | $186.21 | $234.42 | $436.52 |
5 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 $239.88 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Where Alabama sits
The same service costs 36.6 times more in Maine 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
ME $27,224MT $743
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.