How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,738 to $6,310Professionalmedian $355 · 10th to 90th $251 to $562
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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,165.95 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,165.95 | $6,309.57 | $6,309.57 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $323.59 Median $426.58 Typical High $478.63 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $323.59 | $426.58 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,162.28 Typical High $3,981.07 | Facility | None | $549.54 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $457.09 | Professional | None | $338.84 | $354.81 | $457.09 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,698.24 | $3,801.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $575.44 | Professional | None | $213.80 | $281.84 | $575.44 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Where Alabama sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.