How much rates vary
Facilitymedian $1,820 · 10th to 90th $562 to $7,586Professionalmedian $389 · 10th to 90th $50 to $741
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 $707.95 Median $4,365.16 Typical High $12,589.25 | Facility | None | $707.95 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $2,187.76 | Professional | None | $331.13 | $501.19 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $7,585.78 | Facility | None | $588.84 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $562.34 | Professional | None | $263.03 | $331.13 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $1,513.56 Typical High $1,995.26 | Facility | None | $416.87 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $2,511.89 | Facility | None | $489.78 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $794.33 | Professional | None | $398.11 | $575.44 | $794.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $2,454.71 | Facility | None | $512.86 | $1,737.80 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Professional | None | $398.11 | $575.44 | $776.25 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $323.59 Typical High $645.65 | Professional | None | $33.88 | $323.59 | $645.65 |
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 $323.59 Median $426.58 Typical High $616.60 | Professional | None | $323.59 | $426.58 | $616.60 |
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 $281.84 Median $478.63 Typical High $870.96 | Professional | None | $281.84 | $478.63 | $870.96 |
9 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 $251.19 Typical High $281.84 | Professional | 52 · Reduced service | $165.96 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $66.07 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $371.54 Typical High $416.87 | Professional | 54 · Surgery only | $251.19 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $74.13 Typical High $83.18 | Professional | 55 · Aftercare only | $50.12 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.11 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $346.74 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $234.42 | $346.74 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $489.78 Typical High $812.83 | Professional | 50 · Both sides | $389.05 | $489.78 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $54.95 Typical High $263.03 | Professional | 80 · Assistant surgeon | $41.69 | $54.95 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $45.71 Typical High $77.62 | Professional | AS · PA/NP assist | $36.31 | $45.71 | $77.62 |
Where Ohio sits
The same service costs 4.4 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 $6,451MT $1,460
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.