How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,000 to $19,055Professionalmedian $1,349 · 10th to 90th $209 to $2,291
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 $3,890.45 Median $10,000.00 Typical High $13,803.84 | Facility | None | $3,890.45 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $8,317.64 | Professional | None | $1,698.24 | $1,698.24 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $4,677.35 Typical High $21,877.62 | Facility | None | $1,445.44 | $4,677.35 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,698.24 | $2,630.27 |
CareSource Setting Facility Modifier None Typical Low $2,187.76 Median $13,182.57 Typical High $16,982.44 | Facility | None | $2,187.76 | $13,182.57 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $12,882.50 Typical High $22,387.21 | Facility | None | $549.54 | $12,882.50 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,737.80 | $2,238.72 | $3,311.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $12,882.50 Typical High $22,387.21 | Facility | None | $549.54 | $12,882.50 | $22,387.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,737.80 | $2,238.72 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,047.13 Typical High $1,862.09 | Professional | None | $177.83 | $1,047.13 | $1,862.09 |
SummaCare Setting Facility Modifier None Typical Low $6,165.95 Median $6,456.54 Typical High $7,413.10 | Facility | None | $6,165.95 | $6,456.54 | $7,413.10 |
SummaCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,621.81 | $2,089.30 |
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 $1,122.02 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,949.84 | $3,311.31 |
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 $851.14 Median $851.14 Typical High $2,884.03 | Professional | 52 · Reduced service | $851.14 | $851.14 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $1,148.15 | Professional | 53 · Discontinued | $338.84 | $338.84 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $870.96 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $575.44 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,570.40 Typical High $3,890.45 | Professional | 50 · Both sides | $2,041.74 | $2,570.40 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $269.15 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $218.78 | $269.15 | $1,348.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $239.88 Typical High $371.54 | Professional | AS · PA/NP assist | $190.55 | $239.88 | $371.54 |
Where Ohio sits
The same service costs 7.8 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 $31,233KY $3,989
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.