How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,122 to $3,715Professionalmedian $363 · 10th to 90th $288 to $575
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 $371.54 Median $524.81 Typical High $524.81 | Professional | None | $371.54 | $524.81 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $436.52 Median $501.19 Typical High $630.96 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $436.52 | $501.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,621.81 Typical High $2,041.74 | Facility | None | $549.54 | $1,621.81 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $630.96 | Professional | None | $288.40 | $338.84 | $630.96 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,096.48 | $2,454.71 | $5,248.07 |
United Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $436.52 | Professional | None | $257.04 | $323.59 | $436.52 |
7 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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $363.08 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $4,466.84 Median $4,570.88 Typical High $4,570.88 | Facility | 50 · Both sides | $4,466.84 | $4,570.88 | $4,570.88 |
Where Alabama sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.