How much rates vary
Facilitymedian $1,660 · 10th to 90th $759 to $9,772Professionalmedian $1,175 · 10th to 90th $186 to $1,820
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $10,232.93 | Professional | None | $1,230.27 | $1,230.27 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,318.26 Typical High $4,786.30 | Facility | None | $645.65 | $1,318.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,949.84 | Professional | None | $954.99 | $1,202.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $758.58 Typical High $1,230.27 | Professional | 62 · Two surgeons | $602.56 | $758.58 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $316.23 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $275.42 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,737.80 | Facility | None | $1,348.96 | $1,513.56 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $3,388.44 | Facility | None | $794.33 | $1,584.89 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,288.25 | $2,570.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $1,584.89 Typical High $3,388.44 | Facility | None | $851.14 | $1,584.89 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,288.25 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,122.02 Typical High $1,621.81 | Professional | None | $158.49 | $1,122.02 | $1,621.81 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,122.02 | $1,737.80 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,348.96 | $2,818.38 |
6 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 $616.60 Median $616.60 Typical High $2,089.30 | Professional | 52 · Reduced service | $616.60 | $616.60 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $831.76 | Professional | 53 · Discontinued | $245.47 | $245.47 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $3,090.30 | Professional | 54 · Surgery only | $912.01 | $912.01 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $616.60 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $416.87 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $2,884.03 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Delaware. 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 $8,931DE $2,772
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.