How much rates vary
Facilitymedian $2,291 · 10th to 90th $871 to $3,162Professionalmedian $589 · 10th to 90th $195 to $1,380
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 $398.11 Median $588.84 Typical High $1,380.38 | Professional | None | $398.11 | $588.84 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $147.91 Median $204.17 Typical High $295.12 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $147.91 | $204.17 | $295.12 |
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 $218.78 Median $588.84 Typical High $831.76 | Professional | None | $218.78 | $588.84 | $831.76 |
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 $169.82 Median $549.54 Typical High $1,202.26 | Professional | None | $169.82 | $549.54 | $1,202.26 |
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 $199.53 Median $323.59 Typical High $691.83 | Professional | 52 · Reduced service | $199.53 | $323.59 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $128.82 Typical High $275.42 | Professional | 53 · Discontinued | $79.43 | $128.82 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $489.78 Typical High $1,047.13 | Professional | 54 · Surgery only | $295.12 | $489.78 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $97.72 Typical High $208.93 | Professional | 55 · Aftercare only | $58.88 | $97.72 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $64.57 Typical High $138.04 | Professional | 56 · Pre-op care only | $39.81 | $64.57 | $138.04 |
Where Alabama sits
The same service costs 3.8 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 $5,124MT $1,344
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.