How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $9,772Professionalmedian $513 · 10th to 90th $89 to $851
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 $1,148.15 Median $5,128.61 Typical High $12,589.25 | Facility | None | $1,148.15 | $5,128.61 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $3,890.45 | Professional | None | $630.96 | $630.96 | $3,890.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $7,762.47 | Facility | None | $691.83 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,023.29 | Professional | None | $489.78 | $602.56 | $1,023.29 |
Aultcare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $4,365.16 Typical High $5,754.40 | Facility | None | $794.33 | $4,365.16 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,128.61 Typical High $8,317.64 | Facility | None | $741.31 | $5,128.61 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,174.90 | Professional | None | $645.65 | $812.83 | $1,174.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $5,248.07 Typical High $8,128.31 | Facility | None | $741.31 | $5,248.07 | $8,128.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,174.90 | Professional | None | $645.65 | $812.83 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $416.87 Typical High $724.44 | Professional | None | $70.79 | $416.87 | $724.44 |
SummaCare Setting Facility Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $3,388.44 | Facility | None | $2,818.38 | $2,951.21 | $3,388.44 |
SummaCare Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $933.25 | Professional | None | $588.84 | $616.60 | $933.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $398.11 Median $676.08 Typical High $1,148.15 | Professional | None | $398.11 | $676.08 | $1,148.15 |
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 $316.23 Median $316.23 Typical High $1,412.54 | Professional | 52 · Reduced service | $316.23 | $316.23 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $562.34 | Professional | 53 · Discontinued | $125.89 | $125.89 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $2,089.30 | Professional | 54 · Surgery only | $467.74 | $467.74 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $426.58 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $281.84 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $912.01 Typical High $1,479.11 | Professional | 50 · Both sides | $724.44 | $912.01 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $380.19 Typical High $630.96 | Professional | 62 · Two surgeons | $309.03 | $380.19 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $104.71 Typical High $489.78 | Professional | 80 · Assistant surgeon | $77.62 | $104.71 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $85.11 Typical High $141.25 | Professional | AS · PA/NP assist | $67.61 | $85.11 | $141.25 |
Where Ohio sits
The same service costs 5.4 times more in Alaska 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
AK $11,142MT $2,070
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.