How much rates vary
Facilitymedian $3,236 · 10th to 90th $794 to $10,965Professionalmedian $708 · 10th to 90th $158 to $1,259
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 $1,071.52 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,071.52 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,862.09 | Professional | None | $575.44 | $812.83 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $12,022.64 | Facility | None | $645.65 | $2,238.72 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $794.33 | Professional | None | $363.08 | $426.58 | $794.33 |
Aultcare Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $4,365.16 Typical High $5,623.41 | Facility | None | $741.31 | $4,365.16 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,466.84 Typical High $7,585.78 | Facility | None | $794.33 | $4,466.84 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,445.44 | Professional | None | $588.84 | $1,000.00 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $7,585.78 | Facility | None | $851.14 | $4,466.84 | $7,585.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,258.93 | Professional | None | $537.03 | $741.31 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $691.83 Typical High $1,230.27 | Professional | None | $104.71 | $691.83 | $1,230.27 |
SummaCare Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,884.03 | Facility | None | $2,454.71 | $2,570.40 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,202.26 | Professional | None | $575.44 | $831.76 | $1,202.26 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $8,317.64 | Facility | None | $707.95 | $1,905.46 | $8,317.64 |
United Setting Professional Modifier None Typical Low $457.09 Median $794.33 Typical High $1,445.44 | Professional | None | $457.09 | $794.33 | $1,445.44 |
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 $288.40 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $288.40 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $114.82 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $436.52 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $87.10 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $57.54 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $407.38 | $660.69 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $645.65 Typical High $1,174.90 | Professional | 50 · Both sides | $549.54 | $645.65 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $229.09 Median $269.15 Typical High $501.19 | Professional | 62 · Two surgeons | $229.09 | $269.15 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $67.61 Typical High $125.89 | Professional | 80 · Assistant surgeon | $57.54 | $67.61 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $60.26 Typical High $114.82 | Professional | AS · PA/NP assist | $51.29 | $60.26 | $114.82 |
Where Ohio sits
The same service costs 5.1 times more in Alaska 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
AK $10,217WV $2,002
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.