How much rates vary
Facilitymedian $4,898 · 10th to 90th $851 to $13,804Professionalmedian $447 · 10th to 90th $81 to $776
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 $1,659.59 Median $6,606.93 Typical High $12,589.25 | Facility | None | $1,659.59 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $2,089.30 | Professional | None | $537.03 | $602.56 | $2,089.30 |
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 $346.74 Median $407.38 Typical High $812.83 | Professional | None | $346.74 | $407.38 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $8,317.64 Typical High $10,715.19 | Facility | None | $758.58 | $8,317.64 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $9,120.11 Typical High $14,454.40 | Facility | None | $741.31 | $9,120.11 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,122.02 | Professional | None | $616.60 | $776.25 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $9,120.11 Typical High $14,125.38 | Facility | None | $741.31 | $9,120.11 | $14,125.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,122.02 | Professional | None | $616.60 | $776.25 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $389.05 Typical High $676.08 | Professional | None | $70.79 | $389.05 | $676.08 |
SummaCare Setting Facility Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,888.44 | Facility | None | $4,897.79 | $5,128.61 | $5,888.44 |
SummaCare Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $758.58 | Professional | None | $524.81 | $588.84 | $758.58 |
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 $380.19 Median $645.65 Typical High $1,122.02 | Professional | None | $380.19 | $645.65 | $1,122.02 |
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 $302.00 Median $302.00 Typical High $977.24 | Professional | 52 · Reduced service | $302.00 | $302.00 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $389.05 | Professional | 53 · Discontinued | $120.23 | $120.23 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $1,479.11 | Professional | 54 · Surgery only | $446.68 | $446.68 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $295.12 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $194.98 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $616.60 Typical High $1,202.26 | Professional | 50 · Both sides | $524.81 | $616.60 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $316.23 Typical High $478.63 | Professional | 62 · Two surgeons | $257.04 | $316.23 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $66.07 Typical High $131.83 | Professional | 80 · Assistant surgeon | $54.95 | $66.07 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $57.54 Typical High $114.82 | Professional | AS · PA/NP assist | $48.98 | $57.54 | $114.82 |
Where Ohio sits
The same service costs 10.1 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 $19,890MT $1,977
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.