How much rates vary
Facilitymedian $4,571 · 10th to 90th $851 to $11,482Professionalmedian $617 · 10th to 90th $89 to $1,023
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 $1,380.38 Median $5,128.61 Typical High $12,589.25 | Facility | None | $1,380.38 | $5,128.61 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $4,570.88 | Professional | None | $758.58 | $758.58 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,630.78 Typical High $12,302.69 | Facility | None | $891.25 | $3,630.78 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,174.90 | Professional | None | $602.56 | $758.58 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $6,025.60 | Facility | None | $977.24 | $4,570.88 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $741.31 | $5,370.32 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,445.44 | Professional | None | $776.25 | $977.24 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $741.31 | $5,370.32 | $9,332.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,445.44 | Professional | None | $776.25 | $977.24 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $478.63 Typical High $831.76 | Professional | None | $70.79 | $478.63 | $831.76 |
SummaCare Setting Facility Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $3,162.28 | Facility | None | $2,630.27 | $2,754.23 | $3,162.28 |
SummaCare Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $954.99 | Professional | None | $676.08 | $741.31 | $954.99 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $12,022.64 | Facility | None | $912.01 | $3,388.44 | $12,022.64 |
United Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $1,412.54 | Professional | None | $489.78 | $831.76 | $1,412.54 |
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 $380.19 Median $380.19 Typical High $1,548.82 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $630.96 | Professional | 53 · Discontinued | $151.36 | $151.36 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $2,344.23 | Professional | 54 · Surgery only | $562.34 | $562.34 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $467.74 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $309.03 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,122.02 Typical High $1,778.28 | Professional | 50 · Both sides | $912.01 | $1,122.02 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $478.63 Typical High $758.58 | Professional | 62 · Two surgeons | $380.19 | $478.63 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $120.23 Typical High $190.55 | Professional | 80 · Assistant surgeon | $95.50 | $120.23 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $104.71 Typical High $169.82 | Professional | AS · PA/NP assist | $85.11 | $104.71 | $169.82 |
Where Ohio sits
The same service costs 5.9 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 $14,644MT $2,489
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.