How much rates vary
Facilitymedian $1,230 · 10th to 90th $372 to $1,349Professionalmedian $200 · 10th to 90th $120 to $269
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 $158.49 Median $691.83 Typical High $1,737.80 | Facility | None | $158.49 | $691.83 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $257.04 | Professional | None | $158.49 | $177.83 | $257.04 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,230.27 | $1,258.93 | $1,258.93 |
BCBS Alabama Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $275.42 | Professional | None | $199.53 | $269.15 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $549.54 | Facility | None | $338.84 | $407.38 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $275.42 | Professional | None | $162.18 | $186.21 | $275.42 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $263.03 | Professional | None | $93.33 | $141.25 | $263.03 |
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 $89.13 Median $89.13 Typical High $128.82 | Professional | 52 · Reduced service | $89.13 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | 53 · Discontinued | $35.48 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | 54 · Surgery only | $134.90 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $38.90 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $25.70 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $25.70 |
Where Alabama sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.