How much rates vary
Facilitymedian $3,467 · 10th to 90th $708 to $11,220Professionalmedian $1,349 · 10th to 90th $257 to $2,630
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $9,120.11 | Professional | None | $1,995.26 | $1,995.26 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $7,585.78 | Facility | None | $645.65 | $1,737.80 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $2,344.23 | Professional | None | $741.31 | $933.25 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,630.78 Typical High $5,888.44 | Facility | None | $588.84 | $3,630.78 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,630.27 | $3,388.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $3,630.78 Typical High $5,623.41 | Facility | None | $588.84 | $3,630.78 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,630.27 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $1,258.93 Typical High $2,187.76 | Professional | None | $213.80 | $1,258.93 | $2,187.76 |
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 $1,698.24 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,862.09 | $2,454.71 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $3,715.35 | Professional | None | $870.96 | $1,621.81 | $3,715.35 |
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 $1,000.00 Median $1,000.00 Typical High $3,311.31 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $1,348.96 | Professional | 53 · Discontinued | $398.11 | $398.11 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $5,011.87 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $1,000.00 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $676.08 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,412.54 Typical High $3,467.37 | Professional | 50 · Both sides | $1,122.02 | $1,412.54 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $588.84 Typical High $1,479.11 | Professional | 62 · Two surgeons | $467.74 | $588.84 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $169.82 Typical High $741.31 | Professional | 80 · Assistant surgeon | $120.23 | $169.82 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $131.83 Typical High $331.13 | Professional | AS · PA/NP assist | $104.71 | $131.83 | $331.13 |
Where Ohio sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.