How much rates vary
Facilitymedian $2,399 · 10th to 90th $447 to $12,023Professionalmedian $2,239 · 10th to 90th $204 to $3,548
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 $4,265.80 Median $7,762.47 Typical High $12,589.25 | Facility | None | $4,265.80 | $7,762.47 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $9,332.54 | Professional | None | $2,511.89 | $2,818.38 | $9,332.54 |
Ambetter Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $1,905.46 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,290.87 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $371.54 Typical High $575.44 | Professional | 80 · Assistant surgeon | $309.03 | $371.54 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $316.23 Typical High $501.19 | Professional | AS · PA/NP assist | $269.15 | $316.23 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $2,238.72 Median $2,754.23 Typical High $5,128.61 | Professional | None | $2,238.72 | $2,754.23 | $5,128.61 |
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 $2,238.72 Median $2,754.23 Typical High $5,128.61 | Professional | None | $2,238.72 | $2,754.23 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,862.09 Typical High $2,691.53 | Professional | None | $186.21 | $1,862.09 | $2,691.53 |
SummaCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,398.83 | $4,168.69 |
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 $2,344.23 Median $2,951.21 Typical High $6,760.83 | Professional | None | $2,344.23 | $2,951.21 | $6,760.83 |
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 $1,258.93 Median $1,258.93 Typical High $3,715.35 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $1,479.11 | Professional | 53 · Discontinued | $501.19 | $501.19 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $5,495.41 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $1,122.02 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $741.31 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $5,128.61 |
Where Ohio sits
The same service costs 7.1 times more in Alaska 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
AK $20,935WA $2,929
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.