How much rates vary
Facilitymedian $19,055 · 10th to 90th $513 to $19,055Professionalmedian $2,692 · 10th to 90th $1,622 to $3,090
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 $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,344.23 | $2,951.21 | $2,951.21 |
BCBS Alabama Setting Facility Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $19,054.61 | Facility | None | $19,054.61 | $19,054.61 | $19,054.61 |
BCBS Alabama Setting Professional Modifier 21 Typical Low $2,511.89 Median $3,162.28 Typical High $3,890.45 | Professional | 21 | $2,511.89 | $3,162.28 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $3,890.45 | Professional | None | $2,290.87 | $2,691.53 | $3,890.45 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,513.56 | $1,862.09 | $3,090.30 |
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $2,041.74 |
Where Alabama sits
The same service costs 14.0 times more in Maine than in Texas. 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
ME $34,704TX $2,477
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.