How much rates vary
Facilitymedian $1,349 · 10th to 90th $562 to $7,762Professionalmedian $380 · 10th to 90th $79 to $589
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 $1,148.15 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,148.15 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $2,041.74 | Professional | None | $416.87 | $416.87 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $645.65 | Professional | None | $331.13 | $416.87 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $616.60 Typical High $977.24 | Professional | 50 · Both sides | $501.19 | $616.60 | $977.24 |
Aultcare Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $891.25 | Facility | None | $524.81 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $912.01 Typical High $6,025.60 | Facility | None | $602.56 | $912.01 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $776.25 | Professional | None | $426.58 | $537.03 | $776.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $912.01 Typical High $6,025.60 | Facility | None | $602.56 | $912.01 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $776.25 | Professional | None | $426.58 | $537.03 | $776.25 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $316.23 Typical High $501.19 | Professional | None | $67.61 | $316.23 | $501.19 |
SummaCare Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $457.09 | Facility | None | $380.19 | $398.11 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $537.03 | Professional | None | $371.54 | $407.38 | $537.03 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $776.25 | Professional | None | $263.03 | $446.68 | $776.25 |
4 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 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $1,000.00 | Professional | 54 · Surgery only | $309.03 | $309.03 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $66.07 Typical High $102.33 | Professional | 80 · Assistant surgeon | $52.48 | $66.07 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $57.54 Typical High $91.20 | Professional | AS · PA/NP assist | $46.77 | $57.54 | $91.20 |
Where Ohio sits
The same service costs 4.1 times more in Colorado than in West Virginia. 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 $5,160WV $1,245
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.