How much rates vary
Facilitymedian $2,884 · 10th to 90th $933 to $10,715Professionalmedian $603 · 10th to 90th $89 to $1,000
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 $1,412.54 Median $8,317.64 Typical High $12,589.25 | Facility | None | $1,412.54 | $8,317.64 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $5,623.41 | Professional | None | $776.25 | $776.25 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,148.15 | Professional | None | $562.34 | $707.95 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $2,818.38 Typical High $3,630.78 | Facility | None | $977.24 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $3,162.28 Typical High $5,248.07 | Facility | None | $1,071.52 | $3,162.28 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,445.44 | Professional | None | $776.25 | $1,000.00 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,096.48 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,096.48 | $3,235.94 | $5,248.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,412.54 | Professional | None | $776.25 | $1,000.00 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $501.19 Typical High $851.14 | Professional | None | $70.79 | $501.19 | $851.14 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $933.25 | Professional | None | $645.65 | $724.44 | $933.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,445.44 | Professional | None | $501.19 | $812.83 | $1,445.44 |
10 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 $389.05 Median $389.05 Typical High $1,479.11 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $588.84 | Professional | 53 · Discontinued | $154.88 | $154.88 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $2,238.72 | Professional | 54 · Surgery only | $575.44 | $575.44 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $446.68 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $295.12 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,071.52 Typical High $1,698.24 | Professional | 50 · Both sides | $851.14 | $1,071.52 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $724.44 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $112.20 Typical High $186.21 | Professional | 80 · Assistant surgeon | $91.20 | $112.20 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $100.00 Typical High $162.18 | Professional | AS · PA/NP assist | $79.43 | $100.00 | $162.18 |
Where Ohio sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $10,315KY $2,095
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.