How much rates vary
Facilitymedian $3,631 · 10th to 90th $676 to $10,965Professionalmedian $1,288 · 10th to 90th $174 to $2,138
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 $1,584.89 Median $1,584.89 Typical High $7,413.10 | Professional | None | $1,584.89 | $1,584.89 | $7,413.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,258.93 | $1,548.82 | $2,454.71 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,786.30 Typical High $7,943.28 | Facility | None | $588.84 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,621.81 | $2,089.30 | $3,090.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $4,786.30 Typical High $7,413.10 | Facility | None | $588.84 | $4,786.30 | $7,413.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,513.56 | $2,089.30 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $1,023.29 Typical High $1,778.28 | Professional | None | $144.54 | $1,023.29 | $1,778.28 |
SummaCare Setting Facility Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,019.95 | Facility | None | $2,511.89 | $2,630.27 | $3,019.95 |
SummaCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,513.56 | $1,995.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,737.80 | $3,019.95 |
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 $794.33 Median $794.33 Typical High $3,235.94 | Professional | 52 · Reduced service | $794.33 | $794.33 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $1,288.25 | Professional | 53 · Discontinued | $323.59 | $323.59 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $977.24 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $645.65 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,344.23 Typical High $3,715.35 | Professional | 50 · Both sides | $1,862.09 | $2,344.23 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $977.24 Typical High $1,548.82 | Professional | 62 · Two surgeons | $776.25 | $977.24 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $251.19 Typical High $398.11 | Professional | 80 · Assistant surgeon | $199.53 | $251.19 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $218.78 Typical High $346.74 | Professional | AS · PA/NP assist | $173.78 | $218.78 | $346.74 |
Where Ohio sits
The same service costs 4.7 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 $16,761KY $3,604
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.