How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $9,120Professionalmedian $490 · 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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $5,754.40 | Professional | None | $575.44 | $575.44 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $977.24 | Professional | None | $489.78 | $602.56 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $1,513.56 Typical High $1,995.26 | Facility | None | $724.44 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,148.15 | Professional | None | $588.84 | $776.25 | $1,148.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,148.15 | Professional | None | $588.84 | $776.25 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $371.54 Typical High $645.65 | Professional | None | $70.79 | $371.54 | $645.65 |
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 $501.19 Median $549.54 Typical High $724.44 | Professional | None | $501.19 | $549.54 | $724.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $380.19 Median $660.69 Typical High $1,148.15 | Professional | None | $380.19 | $660.69 | $1,148.15 |
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 $288.40 Typical High $1,862.09 | Professional | 52 · Reduced service | $288.40 | $288.40 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $758.58 | Professional | 53 · Discontinued | $114.82 | $114.82 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $2,818.38 | Professional | 54 · Surgery only | $426.58 | $426.58 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $562.34 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $912.01 Typical High $1,445.44 | Professional | 50 · Both sides | $724.44 | $912.01 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $380.19 Typical High $616.60 | Professional | 62 · Two surgeons | $309.03 | $380.19 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $97.72 Typical High $158.49 | Professional | 80 · Assistant surgeon | $77.62 | $97.72 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $85.11 Typical High $141.25 | Professional | AS · PA/NP assist | $67.61 | $85.11 | $141.25 |
Where Ohio sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.