How much rates vary
Facilitymedian $1,950 · 10th to 90th $851 to $2,884Professionalmedian $275 · 10th to 90th $219 to $501
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 $354.81 Median $501.19 Typical High $501.19 | Professional | None | $354.81 | $501.19 | $501.19 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $186.21 Median $257.04 Typical High $354.81 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $186.21 | $257.04 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,023.29 Typical High $1,288.25 | Facility | None | $363.08 | $1,023.29 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $354.81 | Professional | None | $204.17 | $275.42 | $354.81 |
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 $213.80 Median $257.04 Typical High $338.84 | Professional | None | $213.80 | $257.04 | $338.84 |
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 $173.78 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $70.79 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $263.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $52.48 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $35.48 | $50.12 | $50.12 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | 50 · Both sides | $2,951.21 | $2,951.21 | $2,951.21 |
Where Alabama sits
The same service costs 6.4 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 $4,783MT $743
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.