How much rates vary
Facilitymedian $2,138 · 10th to 90th $603 to $10,233Professionalmedian $832 · 10th to 90th $603 to $1,318
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 $1,737.80 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,737.80 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $3,162.28 | Professional | None | $776.25 | $776.25 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,318.26 | Professional | None | $660.69 | $831.76 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $660.69 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $114.82 Typical High $181.97 | Professional | AS · PA/NP assist | $93.33 | $114.82 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,584.89 | Professional | None | $776.25 | $1,047.13 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,584.89 | Professional | None | $776.25 | $1,047.13 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,023.29 | Professional | None | $562.34 | $724.44 | $1,023.29 |
SummaCare Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $933.25 | Professional | None | $645.65 | $707.95 | $933.25 |
United Setting Facility Modifier None Typical Low $891.25 Median $3,162.28 Typical High $10,471.29 | Facility | None | $891.25 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,548.82 | Professional | None | $512.86 | $891.25 | $1,548.82 |
5 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 $1,174.90 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $478.63 | Professional | 53 · Discontinued | $154.88 | $154.88 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $1,778.28 | Professional | 54 · Surgery only | $575.44 | $575.44 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $354.81 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $234.42 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $234.42 |
Where Ohio sits
The same service costs 4.6 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 $9,843KY $2,122
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.