How much rates vary
Facilitymedian $2,291 · 10th to 90th $871 to $3,162Professionalmedian $562 · 10th to 90th $174 to $1,318
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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $616.60 Typical High $1,318.26 | Professional | None | $338.84 | $616.60 | $1,318.26 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $190.55 Median $218.78 Typical High $281.84 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $190.55 | $218.78 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,621.81 Typical High $2,041.74 | Facility | None | $489.78 | $1,621.81 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $562.34 Typical High $741.31 | Professional | None | $186.21 | $562.34 | $741.31 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,265.80 | Facility | None | $758.58 | $1,737.80 | $4,265.80 |
United Setting Professional Modifier None Typical Low $151.36 Median $537.03 Typical High $1,174.90 | Professional | None | $151.36 | $537.03 | $1,174.90 |
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 $169.82 Median $309.03 Typical High $660.69 | Professional | 52 · Reduced service | $169.82 | $309.03 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $123.03 Typical High $263.03 | Professional | 53 · Discontinued | $69.18 | $123.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $467.74 Typical High $1,000.00 | Professional | 54 · Surgery only | $257.04 | $467.74 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $93.33 Typical High $199.53 | Professional | 55 · Aftercare only | $51.29 | $93.33 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $61.66 Typical High $131.83 | Professional | 56 · Pre-op care only | $33.88 | $61.66 | $131.83 |
Where Alabama sits
The same service costs 4.0 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 $5,041MT $1,267
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.