How much rates vary
Facilitymedian $3,890 · 10th to 90th $912 to $11,220Professionalmedian $1,000 · 10th to 90th $135 to $1,660
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 $3,467.37 Median $9,120.11 Typical High $12,589.25 | Facility | None | $3,467.37 | $9,120.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $6,918.31 | Professional | None | $1,258.93 | $1,258.93 | $6,918.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $12,022.64 | Facility | None | $954.99 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,905.46 | Professional | None | $977.24 | $1,230.27 | $1,905.46 |
CareSource Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,623.41 | Facility | None | $4,365.16 | $4,365.16 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,630.78 Typical High $5,888.44 | Facility | None | $794.33 | $3,630.78 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,621.81 | $2,344.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $3,630.78 Typical High $5,623.41 | Facility | None | $851.14 | $3,630.78 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,621.81 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $794.33 Typical High $1,380.38 | Professional | None | $107.15 | $794.33 | $1,380.38 |
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 $1,071.52 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,202.26 | $1,548.82 |
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 $794.33 Median $1,348.96 Typical High $2,344.23 | Professional | None | $794.33 | $1,348.96 | $2,344.23 |
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 $616.60 Median $616.60 Typical High $3,019.95 | Professional | 52 · Reduced service | $616.60 | $616.60 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $1,202.26 | Professional | 53 · Discontinued | $251.19 | $251.19 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $4,570.88 | Professional | 54 · Surgery only | $933.25 | $933.25 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $912.01 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $602.56 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $758.58 Typical High $1,174.90 | Professional | 62 · Two surgeons | $616.60 | $758.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $302.00 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $269.15 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $269.15 |
Where Ohio sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.