How much rates vary
Facilitymedian $1,950 · 10th to 90th $661 to $10,233Professionalmedian $676 · 10th to 90th $89 to $1,096
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,951.21 | Professional | None | $812.83 | $812.83 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,412.54 | Professional | None | $691.83 | $851.14 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,548.82 | Facility | None | $794.33 | $1,023.29 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $2,691.53 | Facility | None | $588.84 | $1,778.28 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,584.89 | Professional | None | $851.14 | $1,096.48 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $2,691.53 | Facility | None | $588.84 | $1,778.28 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,621.81 | Professional | None | $851.14 | $1,096.48 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $501.19 Typical High $891.25 | Professional | None | $70.79 | $501.19 | $891.25 |
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 $707.95 Median $776.25 Typical High $1,023.29 | Professional | None | $707.95 | $776.25 | $1,023.29 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $10,471.29 | Facility | None | $912.01 | $3,388.44 | $10,471.29 |
United Setting Professional Modifier None Typical Low $537.03 Median $933.25 Typical High $1,584.89 | Professional | None | $537.03 | $933.25 | $1,584.89 |
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 $407.38 Median $407.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $549.54 | Professional | 53 · Discontinued | $162.18 | $162.18 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $2,041.74 | Professional | 54 · Surgery only | $616.60 | $616.60 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $416.87 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $275.42 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,288.25 Typical High $2,089.30 | Professional | 50 · Both sides | $1,023.29 | $1,288.25 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $537.03 Typical High $891.25 | Professional | 62 · Two surgeons | $436.52 | $537.03 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $144.54 Typical High $691.83 | Professional | 80 · Assistant surgeon | $109.65 | $144.54 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $120.23 Typical High $199.53 | Professional | AS · PA/NP assist | $95.50 | $120.23 | $199.53 |
Where Ohio sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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
AL $11,256KY $2,261
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.