How much rates vary
Facilitymedian $4,786 · 10th to 90th $871 to $13,490Professionalmedian $724 · 10th to 90th $89 to $1,175
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 $2,398.83 Median $6,606.93 Typical High $12,589.25 | Facility | None | $2,398.83 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $4,570.88 | Professional | None | $870.96 | $870.96 | $4,570.88 |
Ambetter Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $19,054.61 | Facility | None | $891.25 | $3,890.45 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,412.54 | Professional | None | $676.08 | $851.14 | $1,412.54 |
Aultcare Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $8,511.38 Typical High $11,220.18 | Facility | None | $1,096.48 | $8,511.38 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,317.64 Typical High $13,489.63 | Facility | None | $741.31 | $8,317.64 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $891.25 | $1,122.02 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $8,317.64 Typical High $13,182.57 | Facility | None | $741.31 | $8,317.64 | $13,182.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,584.89 | Professional | None | $891.25 | $1,122.02 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $562.34 Typical High $1,000.00 | Professional | None | $70.79 | $562.34 | $1,000.00 |
SummaCare Setting Facility Modifier None Typical Low $4,570.88 Median $4,786.30 Typical High $5,495.41 | Facility | None | $4,570.88 | $4,786.30 | $5,495.41 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,096.48 | Professional | None | $758.58 | $851.14 | $1,096.48 |
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 $562.34 Median $933.25 Typical High $1,621.81 | Professional | None | $562.34 | $933.25 | $1,621.81 |
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 $436.52 Median $436.52 Typical High $1,621.81 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $645.65 | Professional | 53 · Discontinued | $173.78 | $173.78 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $2,454.71 | Professional | 54 · Surgery only | $660.69 | $660.69 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $489.78 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $323.59 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,258.93 Typical High $2,089.30 | Professional | 50 · Both sides | $1,023.29 | $1,258.93 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $537.03 Typical High $891.25 | Professional | 62 · Two surgeons | $426.58 | $537.03 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $144.54 Typical High $676.08 | Professional | 80 · Assistant surgeon | $107.15 | $144.54 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $117.49 Typical High $199.53 | Professional | AS · PA/NP assist | $95.50 | $117.49 | $199.53 |
Where Ohio sits
The same service costs 6.8 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 $19,480MT $2,858
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.