How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $10,715Professionalmedian $741 · 10th to 90th $126 to $1,230
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 $5,370.32 | Professional | None | $870.96 | $870.96 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $12,022.64 | Facility | None | $794.33 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,513.56 | Professional | None | $724.44 | $891.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $151.36 Typical High $724.44 | Professional | 80 · Assistant surgeon | $114.82 | $151.36 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $4,365.16 Typical High $5,623.41 | Facility | None | $1,096.48 | $4,365.16 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,888.44 | Facility | None | $741.31 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,621.81 | Professional | None | $891.25 | $1,096.48 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,623.41 | Facility | None | $741.31 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,621.81 | Professional | None | $891.25 | $1,096.48 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $602.56 Typical High $1,047.13 | Professional | None | $104.71 | $602.56 | $1,047.13 |
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 $812.83 Median $891.25 Typical High $1,174.90 | Professional | None | $812.83 | $891.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $1,621.81 | Professional | None | $562.34 | $954.99 | $1,621.81 |
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 $1,513.56 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $602.56 | Professional | 53 · Discontinued | $173.78 | $173.78 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $2,290.87 | Professional | 54 · Surgery only | $660.69 | $660.69 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $457.09 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $302.00 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $2,137.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $125.89 Typical High $213.80 | Professional | AS · PA/NP assist | $100.00 | $125.89 | $213.80 |
Where Ohio sits
The same service costs 4.2 times more in Colorado 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
CO $12,508MT $2,994
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.