How much rates vary
Facilitymedian $2,692 · 10th to 90th $741 to $10,233Professionalmedian $692 · 10th to 90th $120 to $1,122
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 $831.76 Median $831.76 Typical High $4,168.69 | Professional | None | $831.76 | $831.76 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,348.96 | Professional | None | $691.83 | $870.96 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,047.13 | $1,513.56 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,412.54 | Professional | None | $630.96 | $933.25 | $1,412.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,778.28 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $562.34 Typical High $1,000.00 | Professional | None | $104.71 | $562.34 | $1,000.00 |
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 $758.58 Median $831.76 Typical High $1,096.48 | Professional | None | $758.58 | $831.76 | $1,096.48 |
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 $524.81 Median $891.25 Typical High $1,513.56 | Professional | None | $524.81 | $891.25 | $1,513.56 |
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 $416.87 Median $416.87 Typical High $1,513.56 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $602.56 | Professional | 53 · Discontinued | $165.96 | $165.96 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,238.72 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $457.09 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $302.00 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $549.54 Typical High $870.96 | Professional | 62 · Two surgeons | $436.52 | $549.54 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $138.04 Typical High $218.78 | Professional | 80 · Assistant surgeon | $109.65 | $138.04 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $120.23 Typical High $194.98 | Professional | AS · PA/NP assist | $97.72 | $120.23 | $194.98 |
Where Ohio sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.