How much rates vary
Facilitymedian $2,818 · 10th to 90th $813 to $10,715Professionalmedian $575 · 10th to 90th $81 to $955
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 $1,288.25 Median $8,128.31 Typical High $12,589.25 | Facility | None | $1,288.25 | $8,128.31 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $5,128.61 | Professional | None | $691.83 | $691.83 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $7,762.47 | Facility | None | $724.44 | $1,819.70 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,318.26 | Professional | None | $691.83 | $870.96 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,995.26 | Facility | None | $891.25 | $1,513.56 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,148.15 | Professional | None | $794.33 | $794.33 | $1,148.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,737.80 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $467.74 Typical High $794.33 | Professional | None | $70.79 | $467.74 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $870.96 | Professional | None | $602.56 | $676.08 | $870.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $1,348.96 | Professional | None | $446.68 | $794.33 | $1,348.96 |
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 $346.74 Median $346.74 Typical High $1,288.25 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $512.86 | Professional | 53 · Discontinued | $141.25 | $141.25 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,949.84 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $389.05 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $257.04 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $549.54 Typical High $831.76 | Professional | 62 · Two surgeons | $436.52 | $549.54 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $138.04 Typical High $208.93 | Professional | 80 · Assistant surgeon | $112.20 | $138.04 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $123.03 Typical High $186.21 | Professional | AS · PA/NP assist | $97.72 | $123.03 | $186.21 |
Where Ohio sits
The same service costs 4.4 times more in Wisconsin than in Montana. 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
WI $9,724MT $2,195
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.