How much rates vary
Facilitymedian $3,802 · 10th to 90th $708 to $10,715Professionalmedian $933 · 10th to 90th $135 to $1,549
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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $5,754.40 | Professional | None | $1,148.15 | $1,148.15 | $5,754.40 |
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 $891.25 Median $1,122.02 Typical High $1,819.70 | Professional | None | $891.25 | $1,122.02 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,786.30 Typical High $7,762.47 | Facility | None | $588.84 | $4,786.30 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,479.11 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $4,786.30 Typical High $7,244.36 | Facility | None | $588.84 | $4,786.30 | $7,244.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,479.11 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $758.58 Typical High $1,288.25 | Professional | None | $107.15 | $758.58 | $1,288.25 |
SummaCare Setting Facility Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $2,951.21 | Facility | None | $2,511.89 | $2,630.27 | $2,951.21 |
SummaCare Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,412.54 | Professional | None | $977.24 | $1,096.48 | $1,412.54 |
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 $741.31 Median $1,230.27 Typical High $2,137.96 | Professional | None | $741.31 | $1,230.27 | $2,137.96 |
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 $562.34 Median $562.34 Typical High $2,511.89 | Professional | 52 · Reduced service | $562.34 | $562.34 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $1,023.29 | Professional | 53 · Discontinued | $229.09 | $229.09 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $3,801.89 | Professional | 54 · Surgery only | $851.14 | $851.14 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $758.58 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $512.86 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,691.53 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $707.95 Typical High $1,148.15 | Professional | 62 · Two surgeons | $562.34 | $707.95 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $181.97 Typical High $288.40 | Professional | 80 · Assistant surgeon | $144.54 | $181.97 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $257.04 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $257.04 |
Where Ohio sits
The same service costs 5.5 times more in Alaska than in Texas. 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 $14,559TX $2,668
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.