How much rates vary
Facilitymedian $3,631 · 10th to 90th $759 to $10,965Professionalmedian $813 · 10th to 90th $132 to $1,349
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 $1,000.00 Median $1,000.00 Typical High $5,128.61 | Professional | None | $1,000.00 | $1,000.00 | $5,128.61 |
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 $758.58 Median $954.99 Typical High $1,513.56 | Professional | None | $758.58 | $954.99 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $151.36 Typical High $758.58 | Professional | 80 · Assistant surgeon | $120.23 | $151.36 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,258.93 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,467.37 Typical High $5,888.44 | Facility | None | $676.08 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,258.93 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $691.83 Median $3,467.37 Typical High $5,623.41 | Facility | None | $691.83 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,258.93 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $660.69 Typical High $1,202.26 | Professional | None | $104.71 | $660.69 | $1,202.26 |
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 $891.25 Median $1,000.00 Typical High $1,288.25 | Professional | None | $891.25 | $1,000.00 | $1,288.25 |
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 $630.96 Median $1,047.13 Typical High $1,819.70 | Professional | None | $630.96 | $1,047.13 | $1,819.70 |
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 $501.19 Median $501.19 Typical High $1,621.81 | Professional | 52 · Reduced service | $501.19 | $501.19 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $645.65 | Professional | 53 · Discontinued | $199.53 | $199.53 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $2,398.83 | Professional | 54 · Surgery only | $741.31 | $741.31 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $478.63 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $323.59 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,412.54 Typical High $2,238.72 | Professional | 50 · Both sides | $1,148.15 | $1,412.54 | $2,238.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $131.83 Typical High $218.78 | Professional | AS · PA/NP assist | $107.15 | $131.83 | $218.78 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in Delaware. 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 $12,209DE $3,093
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.