How much rates vary
Facilitymedian $2,884 · 10th to 90th $759 to $9,120Professionalmedian $977 · 10th to 90th $138 to $1,479
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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $9,120.11 | Professional | None | $1,071.52 | $1,071.52 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $7,079.46 | Facility | None | $724.44 | $2,137.96 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,737.80 | Professional | None | $891.25 | $1,047.13 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,548.82 | Facility | None | $794.33 | $1,174.90 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,951.21 Typical High $4,897.79 | Facility | None | $741.31 | $2,951.21 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $2,187.76 | Professional | None | $933.25 | $1,096.48 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $4,570.88 | Facility | None | $741.31 | $3,019.95 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $2,187.76 | Professional | None | $933.25 | $1,096.48 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $812.83 Typical High $1,258.93 | Professional | None | $123.03 | $812.83 | $1,258.93 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,513.56 | Professional | None | $954.99 | $954.99 | $1,513.56 |
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 $933.25 Median $1,202.26 Typical High $2,454.71 | Professional | None | $933.25 | $1,202.26 | $2,454.71 |
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 $537.03 Median $537.03 Typical High $1,819.70 | Professional | 52 · Reduced service | $537.03 | $537.03 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $724.44 | Professional | 53 · Discontinued | $213.80 | $213.80 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $2,691.53 | Professional | 54 · Surgery only | $794.33 | $794.33 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $537.03 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $363.08 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $1,096.48 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $288.40 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $251.19 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $251.19 |
Where Ohio sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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 $11,283KY $2,440
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.