How much rates vary
Facilitymedian $6,918 · 10th to 90th $933 to $20,893Professionalmedian $1,288 · 10th to 90th $178 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 $2,818.38 Median $6,760.83 Typical High $15,848.93 | Facility | None | $2,818.38 | $6,760.83 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $6,309.57 | Professional | None | $1,548.82 | $1,548.82 | $6,309.57 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $5,011.87 Typical High $21,877.62 | Facility | None | $1,000.00 | $5,011.87 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,513.56 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $257.04 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $190.55 | $257.04 | $1,202.26 |
Aultcare Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,698.24 | $1,698.24 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $13,489.63 Typical High $17,782.79 | Facility | None | $1,949.84 | $13,489.63 | $17,782.79 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,905.46 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $14,454.40 Typical High $24,547.09 | Facility | None | $549.54 | $14,454.40 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,584.89 | $2,041.74 | $2,951.21 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $14,454.40 Typical High $24,547.09 | Facility | None | $549.54 | $14,454.40 | $24,547.09 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,041.74 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $1,000.00 Typical High $1,737.80 | Professional | None | $144.54 | $1,000.00 | $1,737.80 |
SummaCare Setting Facility Modifier None Typical Low $6,918.31 Median $7,244.36 Typical High $8,317.64 | Facility | None | $6,918.31 | $7,244.36 | $8,317.64 |
SummaCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,513.56 | $1,949.84 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,467.37 Typical High $15,488.17 | Facility | None | $912.01 | $3,467.37 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,659.59 | $2,884.03 |
9 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 $776.25 Median $776.25 Typical High $2,290.87 | Professional | 52 · Reduced service | $776.25 | $776.25 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $912.01 | Professional | 53 · Discontinued | $309.03 | $309.03 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $676.08 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $457.09 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $3,162.28 |
Ambetter Setting Professional Modifier 22 · Increased work Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 22 · Increased work | $1,348.96 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $954.99 Typical High $1,584.89 | Professional | 62 · Two surgeons | $758.58 | $954.99 | $1,584.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $354.81 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $354.81 |
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 $23,835KY $3,447
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.