How much rates vary
Facilitymedian $3,631 · 10th to 90th $759 to $10,715Professionalmedian $437 · 10th to 90th $79 to $676
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 $1,905.46 Median $8,511.38 Typical High $13,803.84 | Facility | None | $1,905.46 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $5,128.61 | Professional | None | $489.78 | $489.78 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $12,022.64 | Facility | None | $794.33 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $758.58 | Professional | None | $389.05 | $478.63 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $79.43 Typical High $389.05 | Professional | 80 · Assistant surgeon | $61.66 | $79.43 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $67.61 Typical High $107.15 | Professional | AS · PA/NP assist | $53.70 | $67.61 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $3,388.44 Typical High $4,365.16 | Facility | None | $630.96 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,888.44 | Facility | None | $741.31 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $933.25 | Professional | None | $501.19 | $630.96 | $933.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,623.41 | Facility | None | $741.31 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $912.01 | Professional | None | $501.19 | $630.96 | $912.01 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $354.81 Typical High $575.44 | Professional | None | $67.61 | $354.81 | $575.44 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $616.60 | Professional | None | $426.58 | $478.63 | $616.60 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $912.01 | Professional | None | $316.23 | $524.81 | $912.01 |
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 $245.47 Median $245.47 Typical High $870.96 | Professional | 52 · Reduced service | $245.47 | $245.47 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $346.74 | Professional | 53 · Discontinued | $97.72 | $97.72 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $1,318.26 | Professional | 54 · Surgery only | $363.08 | $363.08 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $263.03 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $173.78 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $1,230.27 |
Where Ohio sits
The same service costs 7.5 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 $12,189MT $1,626
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.