How much rates vary
Facilitymedian $3,548 · 10th to 90th $851 to $3,548Professionalmedian $204 · 10th to 90th $155 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 $245.47 Median $954.99 Typical High $1,905.46 | Facility | None | $245.47 | $954.99 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $245.47 | Professional | None | $169.82 | $245.47 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $239.88 Median $281.84 Typical High $389.05 | Professional | 32 · Mandated service | $239.88 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,659.59 Typical High $2,041.74 | Facility | None | $489.78 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $389.05 | Professional | None | $173.78 | $199.53 | $389.05 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $263.03 | Professional | None | $141.25 | $181.97 | $263.03 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $173.78 |
Where Alabama sits
The same service costs 8.1 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 $4,634MT $570
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.