How much rates vary
Facilitymedian $2,818 · 10th to 90th $562 to $2,884Professionalmedian $182 · 10th to 90th $126 to $302
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 $208.93 Median $208.93 Typical High $302.00 | Professional | None | $208.93 | $208.93 | $302.00 |
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 $2,818.38 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,818.38 | $2,884.03 | $2,884.03 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $134.90 Median $186.21 Typical High $281.84 | Professional | 32 · Mandated service | $134.90 | $186.21 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,071.52 Typical High $1,318.26 | Facility | None | $363.08 | $1,071.52 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $263.03 | Professional | None | $134.90 | $181.97 | $263.03 |
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 $112.20 Median $165.96 Typical High $229.09 | Professional | None | $112.20 | $165.96 | $229.09 |
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 $104.71 Median $104.71 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | 53 · Discontinued | $41.69 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $213.80 |
Where Alabama sits
The same service costs 9.9 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 $4,605MT $466
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.