How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,259 to $4,898Professionalmedian $1,000 · 10th to 90th $617 to $1,549
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 $707.95 Median $1,096.48 Typical High $2,344.23 | Facility | None | $707.95 | $1,096.48 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $691.83 | $1,000.00 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $549.54 | Professional | None | $323.59 | $363.08 | $549.54 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
BCBS Alabama Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,548.82 | Professional | None | $977.24 | $1,148.15 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $3,548.13 | Facility | None | $741.31 | $2,818.38 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,584.89 | Professional | None | $602.56 | $776.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,801.89 Typical High $6,456.54 | Facility | None | $1,288.25 | $3,801.89 | $6,456.54 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,023.29 | Professional | None | $575.44 | $724.44 | $1,023.29 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Alabama sits
The same service costs 4.5 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 $10,099MT $2,245
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.