How much rates vary
Facilitymedian $1,738 · 10th to 90th $617 to $7,762Professionalmedian $309 · 10th to 90th $79 to $513
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 $616.60 Median $4,168.69 Typical High $11,220.18 | Facility | None | $616.60 | $4,168.69 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $1,148.15 | Professional | None | $309.03 | $331.13 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $7,585.78 | Facility | None | $602.56 | $1,513.56 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $616.60 | Professional | None | $281.84 | $354.81 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $537.03 Typical High $891.25 | Professional | 50 · Both sides | $426.58 | $537.03 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $60.26 Typical High $281.84 | Professional | 80 · Assistant surgeon | $45.71 | $60.26 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $1,995.26 | Facility | None | $426.58 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $645.65 | Professional | None | $346.74 | $426.58 | $645.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $645.65 | Professional | None | $346.74 | $426.58 | $645.65 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $245.47 Typical High $416.87 | Professional | None | $66.07 | $245.47 | $416.87 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $426.58 | Professional | None | $295.12 | $323.59 | $426.58 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $630.96 | Professional | None | $213.80 | $371.54 | $630.96 |
7 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 $165.96 Median $165.96 Typical High $537.03 | Professional | 52 · Reduced service | $165.96 | $165.96 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $213.80 | Professional | 53 · Discontinued | $66.07 | $66.07 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $812.83 | Professional | 54 · Surgery only | $251.19 | $251.19 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $162.18 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $107.15 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $50.12 Typical High $85.11 | Professional | AS · PA/NP assist | $39.81 | $50.12 | $85.11 |
Where Ohio sits
The same service costs 6.0 times more in Colorado than in Montana. 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
CO $6,645MT $1,112
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.