How much rates vary
Facilitymedian $1,995 · 10th to 90th $851 to $2,884Professionalmedian $525 · 10th to 90th $316 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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $575.44 | Professional | None | $363.08 | $575.44 | $575.44 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
BCBS Alabama Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $660.69 | Professional | None | $478.63 | $602.56 | $660.69 |
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 $436.52 Median $524.81 Typical High $691.83 | Professional | None | $436.52 | $524.81 | $691.83 |
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 $281.84 Median $346.74 Typical High $575.44 | Professional | None | $281.84 | $346.74 | $575.44 |
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 $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $407.38 |
Where Alabama sits
The same service costs 4.0 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 $4,866MT $1,221
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.