How much rates vary
Facilitymedian $1,259 · 10th to 90th $832 to $2,884Professionalmedian $407 · 10th to 90th $219 to $661
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 $489.78 Median $891.25 Typical High $1,862.09 | Facility | None | $489.78 | $891.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $660.69 | Professional | None | $302.00 | $389.05 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $741.31 | Professional | None | $223.87 | $416.87 | $741.31 |
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 $295.12 Median $407.38 Typical High $575.44 | Professional | None | $295.12 | $407.38 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $912.01 Typical High $1,122.02 | Facility | None | $363.08 | $912.01 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $575.44 | Professional | None | $229.09 | $380.19 | $575.44 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,073.80 | Facility | None | $758.58 | $1,737.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $660.69 | Professional | None | $186.21 | $338.84 | $660.69 |
8 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 $151.36 Median $181.97 Typical High $323.59 | Professional | 52 · Reduced service | $151.36 | $181.97 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $72.44 Typical High $131.83 | Professional | 53 · Discontinued | $60.26 | $72.44 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $269.15 Typical High $489.78 | Professional | 54 · Surgery only | $229.09 | $269.15 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $54.95 Typical High $97.72 | Professional | 55 · Aftercare only | $45.71 | $54.95 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $36.31 Typical High $66.07 | Professional | 56 · Pre-op care only | $30.20 | $36.31 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $251.19 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $213.80 | $251.19 | $457.09 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $616.60 Typical High $616.60 | Professional | 50 · Both sides | $257.04 | $616.60 | $616.60 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | 50 · Both sides | $1,862.09 | $1,862.09 | $1,862.09 |
Where Alabama sits
The same service costs 4.6 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 $4,728MT $1,029
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.