How much rates vary
Facilitymedian $1,862 · 10th to 90th $661 to $8,511Professionalmedian $490 · 10th to 90th $74 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 $1,412.54 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,412.54 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $3,801.89 | Professional | None | $512.86 | $512.86 | $3,801.89 |
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 $407.38 Median $501.19 Typical High $812.83 | Professional | None | $407.38 | $501.19 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $85.11 Typical High $407.38 | Professional | 80 · Assistant surgeon | $64.57 | $85.11 | $407.38 |
Aultcare Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $1,513.56 Typical High $1,995.26 | Facility | None | $645.65 | $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 $524.81 Median $660.69 Typical High $954.99 | Professional | None | $524.81 | $660.69 | $954.99 |
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 $524.81 Median $660.69 Typical High $954.99 | Professional | None | $524.81 | $660.69 | $954.99 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $389.05 Typical High $630.96 | Professional | None | $63.10 | $389.05 | $630.96 |
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 $467.74 Median $512.86 Typical High $660.69 | Professional | None | $467.74 | $512.86 | $660.69 |
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 $331.13 Median $549.54 Typical High $954.99 | Professional | None | $331.13 | $549.54 | $954.99 |
9 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 $257.04 Median $257.04 Typical High $1,230.27 | Professional | 52 · Reduced service | $257.04 | $257.04 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $489.78 | Professional | 53 · Discontinued | $102.33 | $102.33 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $1,819.70 | Professional | 54 · Surgery only | $380.19 | $380.19 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $363.08 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $245.47 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $758.58 Typical High $1,202.26 | Professional | 50 · Both sides | $602.56 | $758.58 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $316.23 Typical High $512.86 | Professional | 62 · Two surgeons | $257.04 | $316.23 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $70.79 Typical High $112.20 | Professional | AS · PA/NP assist | $56.23 | $70.79 | $112.20 |
Where Ohio sits
The same service costs 4.5 times more in Connecticut 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
CT $7,632MT $1,703
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.