How much rates vary
Facilitymedian $3,802 · 10th to 90th $724 to $10,715Professionalmedian $832 · 10th to 90th $89 to $1,380
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $5,754.40 | Professional | None | $1,023.29 | $1,023.29 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $12,022.64 | Facility | None | $812.83 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,659.59 | Professional | None | $724.44 | $912.01 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,318.26 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,888.44 | Facility | None | $602.56 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,288.25 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,623.41 | Facility | None | $602.56 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,288.25 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $660.69 Typical High $1,202.26 | Professional | None | $70.79 | $660.69 | $1,202.26 |
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 $912.01 Median $1,000.00 Typical High $1,318.26 | Professional | None | $912.01 | $1,000.00 | $1,318.26 |
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 $645.65 Median $1,071.52 Typical High $1,905.46 | Professional | None | $645.65 | $1,071.52 | $1,905.46 |
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 $512.86 Median $512.86 Typical High $1,621.81 | Professional | 52 · Reduced service | $512.86 | $512.86 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $645.65 | Professional | 53 · Discontinued | $204.17 | $204.17 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $2,454.71 | Professional | 54 · Surgery only | $776.25 | $776.25 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $489.78 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $323.59 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $2,454.71 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $575.44 Typical High $1,047.13 | Professional | 62 · Two surgeons | $457.09 | $575.44 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $263.03 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $234.42 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $234.42 |
Where Ohio sits
The same service costs 5.1 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 $14,362HI $2,794
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.