How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,023 to $44,668Professionalmedian $871 · 10th to 90th $78 to $1,514
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 $1,737.80 Median $8,317.64 Typical High $13,803.84 | Facility | None | $1,737.80 | $8,317.64 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $10,715.19 | Professional | None | $1,000.00 | $1,737.80 | $10,715.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $26,915.35 | Facility | None | $1,479.11 | $5,128.61 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,548.82 | Professional | None | $741.31 | $870.96 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $562.34 Typical High $977.24 | Professional | 62 · Two surgeons | $467.74 | $562.34 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $23,988.33 Typical High $31,622.78 | Facility | None | $1,096.48 | $23,988.33 | $31,622.78 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $26,302.68 Typical High $44,668.36 | Facility | None | $549.54 | $26,302.68 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,949.84 | Professional | None | $851.14 | $1,122.02 | $1,949.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $562.34 Median $25,703.96 Typical High $44,668.36 | Facility | None | $562.34 | $25,703.96 | $44,668.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $2,041.74 | Professional | None | $851.14 | $1,122.02 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $758.58 Typical High $1,047.13 | Professional | None | $64.57 | $758.58 | $1,047.13 |
SummaCare Setting Facility Modifier None Typical Low $12,882.50 Median $13,489.63 Typical High $15,135.61 | Facility | None | $12,882.50 | $13,489.63 | $15,135.61 |
SummaCare Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,778.28 | Professional | None | $812.83 | $954.99 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $10,000.00 Typical High $53,703.18 | Facility | None | $1,288.25 | $10,000.00 | $53,703.18 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,691.53 | Professional | None | $954.99 | $1,202.26 | $2,691.53 |
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 $501.19 Median $501.19 Typical High $1,412.54 | Professional | 52 · Reduced service | $501.19 | $501.19 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $562.34 | Professional | 53 · Discontinued | $199.53 | $199.53 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $2,089.30 | Professional | 54 · Surgery only | $741.31 | $741.31 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $426.58 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $281.84 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $1,949.84 |
Where Ohio sits
The same service costs 19.9 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 $53,750MT $2,699
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.