How much rates vary
Facilitymedian $5,623 · 10th to 90th $977 to $14,454Professionalmedian $1,288 · 10th to 90th $214 to $2,138
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 $3,548.13 Median $10,232.93 Typical High $19,498.45 | Facility | None | $3,548.13 | $10,232.93 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $7,762.47 | Professional | None | $1,621.81 | $1,621.81 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,467.37 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,445.44 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $257.04 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $186.21 | $257.04 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $8,709.64 Typical High $14,791.08 | Facility | None | $549.54 | $8,709.64 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,659.59 | $2,137.96 | $3,090.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $8,709.64 Typical High $14,125.38 | Facility | None | $549.54 | $8,709.64 | $14,125.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,137.96 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,071.52 Typical High $1,862.09 | Professional | None | $177.83 | $1,071.52 | $1,862.09 |
SummaCare Setting Facility Modifier None Typical Low $4,786.30 Median $5,011.87 Typical High $5,623.41 | Facility | None | $4,786.30 | $5,011.87 | $5,623.41 |
SummaCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,584.89 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,737.80 | $3,019.95 |
8 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 $812.83 Median $812.83 Typical High $1,778.28 | Professional | 52 · Reduced service | $812.83 | $812.83 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $707.95 | Professional | 53 · Discontinued | $323.59 | $323.59 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $537.03 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $354.81 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $912.01 Typical High $1,548.82 | Professional | 62 · Two surgeons | $741.31 | $912.01 | $1,548.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $346.74 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $346.74 |
Where Ohio sits
The same service costs 6.9 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 $24,544KY $3,572
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.