How much rates vary
Facilitymedian $1,995 · 10th to 90th $759 to $9,120Professionalmedian $741 · 10th to 90th $89 to $1,202
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $5,128.61 | Professional | None | $870.96 | $870.96 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $7,762.47 | Facility | None | $691.83 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,412.54 | Professional | None | $707.95 | $891.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $144.54 Typical High $707.95 | Professional | 80 · Assistant surgeon | $112.20 | $144.54 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,096.48 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $3,019.95 | Facility | None | $741.31 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $891.25 | $1,122.02 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,951.21 | Facility | None | $741.31 | $1,737.80 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,584.89 | Professional | None | $891.25 | $1,122.02 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $588.84 Typical High $1,023.29 | Professional | None | $70.79 | $588.84 | $1,023.29 |
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 $776.25 Median $851.14 Typical High $1,122.02 | Professional | None | $776.25 | $851.14 | $1,122.02 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $549.54 Median $933.25 Typical High $1,584.89 | Professional | None | $549.54 | $933.25 | $1,584.89 |
7 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 $436.52 Median $436.52 Typical High $1,548.82 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $616.60 | Professional | 53 · Discontinued | $173.78 | $173.78 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $2,344.23 | Professional | 54 · Surgery only | $645.65 | $645.65 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $467.74 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $309.03 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $2,187.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $123.03 Typical High $199.53 | Professional | AS · PA/NP assist | $97.72 | $123.03 | $199.53 |
Where Ohio sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.