How much rates vary
Facilitymedian $2,951 · 10th to 90th $501 to $14,125Professionalmedian $4,074 · 10th to 90th $575 to $6,607
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 $4,786.30 Median $10,715.19 Typical High $13,803.84 | Facility | None | $4,786.30 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $16,595.87 | Professional | None | $4,786.30 | $4,786.30 | $16,595.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $4,677.35 Typical High $21,877.62 | Facility | None | $1,479.11 | $4,677.35 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $6,456.54 | Professional | None | $2,884.03 | $3,630.78 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,819.70 Median $2,238.72 Typical High $4,073.80 | Professional | 62 · Two surgeons | $1,819.70 | $2,238.72 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $575.44 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $457.09 | $575.44 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $7,585.78 | Professional | None | $3,890.45 | $3,981.07 | $7,585.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,888.44 | Professional | None | $5,623.41 | $5,623.41 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $3,981.07 Typical High $6,165.95 | Professional | None | $537.03 | $3,981.07 | $6,165.95 |
SummaCare Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $6,025.60 | Professional | None | $4,677.35 | $4,677.35 | $6,025.60 |
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 $3,162.28 Median $5,128.61 Typical High $11,220.18 | Professional | None | $3,162.28 | $5,128.61 | $11,220.18 |
7 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 $2,398.83 Median $2,398.83 Typical High $12,302.69 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $12,302.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $5,011.87 | Professional | 53 · Discontinued | $954.99 | $954.99 | $5,011.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $3,548.13 Typical High $18,620.87 | Professional | 54 · Surgery only | $3,548.13 | $3,548.13 | $18,620.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $707.95 Typical High $3,715.35 | Professional | 55 · Aftercare only | $707.95 | $707.95 | $3,715.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $2,511.89 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $2,511.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,311.31 Median $3,311.31 Typical High $17,378.01 | Professional | 78 · Unplanned return to OR | $3,311.31 | $3,311.31 | $17,378.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $501.19 Typical High $912.01 | Professional | AS · PA/NP assist | $407.38 | $501.19 | $912.01 |
Where Ohio sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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
WI $28,671TX $3,407
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.