How much rates vary
Facilitymedian $1,995 · 10th to 90th $759 to $9,120Professionalmedian $646 · 10th to 90th $89 to $1,047
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $5,128.61 | Professional | None | $794.33 | $794.33 | $5,128.61 |
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 $602.56 Median $741.31 Typical High $1,202.26 | Professional | None | $602.56 | $741.31 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,000.00 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $3,019.95 | Facility | None | $741.31 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,479.11 | Professional | None | $812.83 | $1,023.29 | $1,479.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,951.21 | Facility | None | $741.31 | $1,737.80 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,445.44 | Professional | None | $812.83 | $1,023.29 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $524.81 Typical High $912.01 | Professional | None | $70.79 | $524.81 | $912.01 |
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 $691.83 Median $776.25 Typical High $1,000.00 | Professional | None | $691.83 | $776.25 | $1,000.00 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $501.19 Median $851.14 Typical High $1,445.44 | Professional | None | $501.19 | $851.14 | $1,445.44 |
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 $389.05 Median $389.05 Typical High $1,479.11 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $588.84 | Professional | 53 · Discontinued | $158.49 | $158.49 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $588.84 | $588.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $446.68 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $295.12 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,122.02 Typical High $1,819.70 | Professional | 50 · Both sides | $891.25 | $1,122.02 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $467.74 Typical High $758.58 | Professional | 62 · Two surgeons | $380.19 | $467.74 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $120.23 Typical High $194.98 | Professional | 80 · Assistant surgeon | $95.50 | $120.23 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $104.71 Typical High $169.82 | Professional | AS · PA/NP assist | $83.18 | $104.71 | $169.82 |
Where Ohio sits
The same service costs 3.1 times more in Wisconsin than in Maryland. 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
WI $8,115MD $2,591
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.