How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $9,120Professionalmedian $759 · 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 $2,344.23 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 $891.25 Median $891.25 Typical High $5,754.40 | Professional | None | $891.25 | $891.25 | $5,754.40 |
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 $676.08 Median $831.76 Typical High $1,412.54 | Professional | None | $676.08 | $831.76 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $144.54 Typical High $676.08 | Professional | 80 · Assistant surgeon | $107.15 | $144.54 | $676.08 |
Aultcare Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,122.02 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
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 $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio 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 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $630.96 Typical High $1,071.52 | Professional | None | $104.71 | $630.96 | $1,071.52 |
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 $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 $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $562.34 Median $933.25 Typical High $1,621.81 | Professional | None | $562.34 | $933.25 | $1,621.81 |
8 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 $446.68 Median $446.68 Typical High $1,412.54 | Professional | 52 · Reduced service | $446.68 | $446.68 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $575.44 | Professional | 53 · Discontinued | $177.83 | $177.83 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $2,137.96 | Professional | 54 · Surgery only | $676.08 | $676.08 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $426.58 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $288.40 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $524.81 Typical High $891.25 | Professional | 62 · Two surgeons | $426.58 | $524.81 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $117.49 Typical High $199.53 | Professional | AS · PA/NP assist | $93.33 | $117.49 | $199.53 |
Where Ohio sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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
AK $8,167HI $2,648
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.