How much rates vary
Facilitymedian $1,413 · 10th to 90th $501 to $1,905Professionalmedian $186 · 10th to 90th $72 to $525
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 $151.36 Median $190.55 Typical High $524.81 | Professional | None | $151.36 | $190.55 | $524.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $97.72 Typical High $263.03 | Professional | 52 · Reduced service | $75.86 | $97.72 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $104.71 | Professional | 53 · Discontinued | $30.20 | $38.90 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $144.54 Typical High $389.05 | Professional | 54 · Surgery only | $114.82 | $144.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.84 Typical High $79.43 | Professional | 55 · Aftercare only | $22.91 | $28.84 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $52.48 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $52.48 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
BCBS Alabama Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $933.25 | Facility | None | $251.19 | $309.03 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $186.21 Typical High $239.88 | Professional | None | $83.18 | $186.21 | $239.88 |
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 $61.66 Median $165.96 Typical High $302.00 | Professional | None | $61.66 | $165.96 | $302.00 |
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 $194.98 Median $269.15 Typical High $389.05 | Professional | 32 · Mandated service | $194.98 | $269.15 | $389.05 |
Where Alabama sits
The same service costs 9.0 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 $4,579MT $507
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.