How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,479 to $6,761Professionalmedian $1,585 · 10th to 90th $1,175 to $2,239
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 $954.99 Median $1,778.28 Typical High $2,630.27 | Facility | None | $954.99 | $1,778.28 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,606.93 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,606.93 | $6,760.83 | $6,760.83 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,862.09 Median $2,137.96 Typical High $2,630.27 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,862.09 | $2,137.96 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,884.03 Typical High $3,548.13 | Facility | None | $1,023.29 | $2,884.03 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,584.89 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,288.25 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,318.26 | $1,995.26 |
7 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 $977.24 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,380.38 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | 50 · Both sides | $10,000.00 | $10,000.00 | $10,000.00 |
Where Alabama sits
The same service costs 3.0 times more in Alaska than in Vermont. 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
AK $12,999VT $4,294
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.