How much rates vary
Facilitymedian $3,631 · 10th to 90th $741 to $10,965Professionalmedian $479 · 10th to 90th $79 to $724
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 $1,479.11 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,479.11 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $4,168.69 | Professional | None | $537.03 | $537.03 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $3,630.78 Typical High $12,022.64 | Facility | None | $812.83 | $3,630.78 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $812.83 | Professional | None | $407.38 | $512.86 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $776.25 Typical High $1,230.27 | Professional | 50 · Both sides | $616.60 | $776.25 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $3,388.44 Typical High $4,365.16 | Facility | None | $676.08 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,888.44 | Facility | None | $602.56 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,623.41 | Facility | None | $602.56 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $398.11 Typical High $630.96 | Professional | None | $67.61 | $398.11 | $630.96 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $676.08 | Professional | None | $467.74 | $524.81 | $676.08 |
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 $338.84 Median $575.44 Typical High $977.24 | Professional | None | $338.84 | $575.44 | $977.24 |
8 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 $263.03 Median $263.03 Typical High $1,548.82 | Professional | 52 · Reduced service | $263.03 | $263.03 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $616.60 | Professional | 53 · Discontinued | $107.15 | $107.15 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $2,290.87 | Professional | 54 · Surgery only | $398.11 | $398.11 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $457.09 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $309.03 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $81.28 Typical High $131.83 | Professional | 80 · Assistant surgeon | $66.07 | $81.28 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $72.44 Typical High $114.82 | Professional | AS · PA/NP assist | $57.54 | $72.44 | $114.82 |
Where Ohio sits
The same service costs 7.9 times more in Colorado 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
CO $13,941MT $1,762
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.