How much rates vary
Facilitymedian $5,370 · 10th to 90th $513 to $5,495Professionalmedian $1,738 · 10th to 90th $1,175 to $3,162
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 $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,621.81 | $3,162.28 | $3,162.28 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,370.32 | $5,495.41 | $5,495.41 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,148.15 Median $1,584.89 Typical High $2,238.72 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,148.15 | $1,584.89 | $2,238.72 |
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 $1,174.90 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,737.80 | $2,041.74 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,548.82 | $2,884.03 |
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,238.72 |
Where Alabama sits
The same service costs 8.1 times more in Maine than in Maryland. 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 $17,891MD $2,222
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.