How much rates vary
Facilitymedian $1,380 · 10th to 90th $603 to $6,607Professionalmedian $363 · 10th to 90th $85 to $617
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 $602.56 Median $1,513.56 Typical High $10,715.19 | Facility | None | $602.56 | $1,513.56 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $1,174.90 | Professional | None | $331.13 | $457.09 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,548.82 Typical High $7,585.78 | Facility | None | $616.60 | $1,548.82 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $512.86 | Professional | None | $263.03 | $331.13 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $1,174.90 Typical High $1,513.56 | Facility | None | $416.87 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $2,187.76 | Facility | None | $549.54 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $758.58 | Professional | None | $346.74 | $489.78 | $758.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $2,187.76 | Facility | None | $549.54 | $1,318.26 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $758.58 | Professional | None | $346.74 | $489.78 | $758.58 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $316.23 Typical High $549.54 | Professional | None | $69.18 | $316.23 | $549.54 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $645.65 | Professional | None | $323.59 | $478.63 | $645.65 |
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 $263.03 Median $426.58 Typical High $758.58 | Professional | None | $263.03 | $426.58 | $758.58 |
5 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 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $501.19 Typical High $758.58 | Professional | 50 · Both sides | $398.11 | $501.19 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $53.70 Typical High $83.18 | Professional | 80 · Assistant surgeon | $42.66 | $53.70 | $83.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $46.77 Typical High $72.44 | Professional | AS · PA/NP assist | $37.15 | $46.77 | $72.44 |
Where Ohio sits
The same service costs 6.0 times more in Colorado than in West Virginia. 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 $6,136WV $1,026
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.