How much rates vary
Facilitymedian $3,467 · 10th to 90th $692 to $11,220Professionalmedian $1,023 · 10th to 90th $135 to $1,905
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $9,120.11 | Professional | None | $1,445.44 | $1,445.44 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,819.70 | Professional | None | $645.65 | $831.76 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,630.78 Typical High $5,888.44 | Facility | None | $588.84 | $3,630.78 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,905.46 | $2,511.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $3,630.78 Typical High $5,623.41 | Facility | None | $588.84 | $3,630.78 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,905.46 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $912.01 Typical High $1,621.81 | Professional | None | $107.15 | $912.01 | $1,621.81 |
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 $1,258.93 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,380.38 | $1,819.70 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,691.53 | Professional | None | $794.33 | $1,258.93 | $2,691.53 |
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 $724.44 Median $724.44 Typical High $2,454.71 | Professional | 52 · Reduced service | $724.44 | $724.44 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $977.24 | Professional | 53 · Discontinued | $288.40 | $288.40 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $741.31 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $489.78 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,230.27 Typical High $2,630.27 | Professional | 50 · Both sides | $977.24 | $1,230.27 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $512.86 Typical High $1,122.02 | Professional | 62 · Two surgeons | $407.38 | $512.86 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $151.36 Typical High $645.65 | Professional | 80 · Assistant surgeon | $104.71 | $151.36 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $251.19 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $251.19 |
Where Ohio sits
The same service costs 5.5 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 $15,938KY $2,890
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.