How much rates vary
Facilitymedian $4,365 · 10th to 90th $741 to $10,965Professionalmedian $603 · 10th to 90th $91 to $977
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 $2,137.96 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,137.96 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $2,454.71 | Professional | None | $630.96 | $724.44 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $3,630.78 Typical High $12,022.64 | Facility | None | $831.76 | $3,630.78 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,174.90 | Professional | None | $575.44 | $724.44 | $1,174.90 |
Aultcare Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $4,570.88 Typical High $6,025.60 | Facility | None | $912.01 | $4,570.88 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,570.88 Typical High $7,244.36 | Facility | None | $602.56 | $4,570.88 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,380.38 | Professional | None | $741.31 | $954.99 | $1,380.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $4,570.88 Typical High $7,244.36 | Facility | None | $602.56 | $4,570.88 | $7,244.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,380.38 | Professional | None | $741.31 | $954.99 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $457.09 Typical High $794.33 | Professional | None | $70.79 | $457.09 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $2,951.21 | Facility | None | $2,511.89 | $2,630.27 | $2,951.21 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $891.25 | Professional | None | $616.60 | $691.83 | $891.25 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $1,380.38 | Professional | None | $478.63 | $794.33 | $1,380.38 |
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 $363.08 Median $363.08 Typical High $1,071.52 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $426.58 | Professional | 53 · Discontinued | $144.54 | $144.54 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $1,621.81 | Professional | 54 · Surgery only | $549.54 | $549.54 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $323.59 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $213.80 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,096.48 Typical High $1,778.28 | Professional | 50 · Both sides | $870.96 | $1,096.48 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $457.09 Typical High $741.31 | Professional | 62 · Two surgeons | $363.08 | $457.09 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $114.82 Typical High $190.55 | Professional | 80 · Assistant surgeon | $93.33 | $114.82 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $165.96 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $165.96 |
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 $14,230MT $2,377
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.