How much rates vary
Facilitymedian $6,166 · 10th to 90th $741 to $15,849Professionalmedian $891 · 10th to 90th $135 to $1,445
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 $3,548.13 Median $10,232.93 Typical High $19,054.61 | Facility | None | $3,548.13 | $10,232.93 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $6,760.83 | Professional | None | $1,096.48 | $1,096.48 | $6,760.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,819.70 Typical High $21,379.62 | Facility | None | $645.65 | $1,819.70 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,698.24 | Professional | None | $851.14 | $1,071.52 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $9,332.54 Typical High $15,488.17 | Facility | None | $588.84 | $9,332.54 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,445.44 | $2,089.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $9,332.54 Typical High $15,488.17 | Facility | None | $588.84 | $9,332.54 | $15,488.17 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,445.44 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $707.95 Typical High $1,202.26 | Professional | None | $107.15 | $707.95 | $1,202.26 |
SummaCare Setting Facility Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $5,370.32 | Facility | None | $4,466.84 | $4,677.35 | $5,370.32 |
SummaCare Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,380.38 | Professional | None | $954.99 | $1,047.13 | $1,380.38 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,467.37 Typical High $12,882.50 | Facility | None | $912.01 | $3,467.37 | $12,882.50 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,174.90 Typical High $2,041.74 | Professional | None | $707.95 | $1,174.90 | $2,041.74 |
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 $549.54 Median $549.54 Typical High $2,344.23 | Professional | 52 · Reduced service | $549.54 | $549.54 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $954.99 | Professional | 53 · Discontinued | $218.78 | $218.78 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $3,548.13 | Professional | 54 · Surgery only | $831.76 | $831.76 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $707.95 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $478.63 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,584.89 Typical High $2,511.89 | Professional | 50 · Both sides | $1,258.93 | $1,584.89 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $676.08 Typical High $1,071.52 | Professional | 62 · Two surgeons | $537.03 | $676.08 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $173.78 Typical High $851.14 | Professional | 80 · Assistant surgeon | $134.90 | $173.78 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $147.91 Typical High $239.88 | Professional | AS · PA/NP assist | $117.49 | $147.91 | $239.88 |
Where Ohio sits
The same service costs 10.4 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 $29,118KY $2,808
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.