How much rates vary
Facilitymedian $1,479 · 10th to 90th $603 to $7,762Professionalmedian $1,000 · 10th to 90th $135 to $1,698
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 $1,380.38 Median $1,380.38 Typical High $5,754.40 | Professional | None | $1,380.38 | $1,380.38 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,584.89 Typical High $7,585.78 | Facility | None | $616.60 | $1,584.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,737.80 | Professional | None | $741.31 | $933.25 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,778.28 | Facility | None | $1,174.90 | $1,513.56 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,698.24 | $2,344.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,698.24 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $870.96 Typical High $1,513.56 | Professional | None | $107.15 | $870.96 | $1,513.56 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,318.26 | $1,737.80 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,511.89 | Professional | None | $812.83 | $1,174.90 | $2,511.89 |
10 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 $691.83 Median $691.83 Typical High $2,511.89 | Professional | 52 · Reduced service | $691.83 | $691.83 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,000.00 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $758.58 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $501.19 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $2,630.27 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $575.44 Typical High $1,096.48 | Professional | 62 · Two surgeons | $467.74 | $575.44 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $147.91 Typical High $281.84 | Professional | 80 · Assistant surgeon | $117.49 | $147.91 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $245.47 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $245.47 |
Where Ohio sits
The same service costs 3.7 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 $8,917DE $2,410
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.