How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $12,589Professionalmedian $1,413 · 10th to 90th $174 to $2,138
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 $10,232.93 Typical High $13,803.84 | Facility | None | $1,412.54 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $6,309.57 | Professional | None | $1,412.54 | $1,412.54 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,513.56 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,737.80 | $3,090.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,737.80 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,174.90 Typical High $1,862.09 | Professional | None | $162.18 | $1,174.90 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,380.38 | $2,089.30 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,258.93 | $1,584.89 | $3,235.94 |
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 $707.95 Median $707.95 Typical High $2,818.38 | Professional | 52 · Reduced service | $707.95 | $707.95 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $1,122.02 | Professional | 53 · Discontinued | $281.84 | $281.84 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $4,168.69 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $851.14 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $562.34 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $954.99 Typical High $1,479.11 | Professional | 62 · Two surgeons | $758.58 | $954.99 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $239.88 Typical High $389.05 | Professional | 80 · Assistant surgeon | $190.55 | $239.88 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $331.13 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $331.13 |
Where Ohio sits
The same service costs 7.8 times more in Colorado than in Washington. 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 $16,544WA $2,120
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.