How much rates vary
Facilitymedian $2,399 · 10th to 90th $447 to $12,023Professionalmedian $2,291 · 10th to 90th $204 to $3,631
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 $4,466.84 Median $8,128.31 Typical High $12,589.25 | Facility | None | $4,466.84 | $8,128.31 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $9,772.37 | Professional | None | $2,511.89 | $2,630.27 | $9,772.37 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $3,388.44 | Professional | None | $1,318.26 | $1,318.26 | $3,388.44 |
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 $1,949.84 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,949.84 | $2,344.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,479.11 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,230.27 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $380.19 Typical High $645.65 | Professional | 80 · Assistant surgeon | $309.03 | $380.19 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $331.13 Typical High $537.03 | Professional | AS · PA/NP assist | $275.42 | $331.13 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $2,344.23 Median $2,884.03 Typical High $5,370.32 | Professional | None | $2,344.23 | $2,884.03 | $5,370.32 |
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 $2,344.23 Median $2,884.03 Typical High $5,370.32 | Professional | None | $2,344.23 | $2,884.03 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,995.26 Typical High $2,884.03 | Professional | None | $186.21 | $1,995.26 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $4,677.35 | Professional | None | $2,290.87 | $2,691.53 | $4,677.35 |
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 $2,454.71 Median $3,090.30 Typical High $7,079.46 | Professional | None | $2,454.71 | $3,090.30 | $7,079.46 |
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 $1,318.26 Median $1,318.26 Typical High $4,466.84 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $1,778.28 | Professional | 53 · Discontinued | $524.81 | $524.81 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $6,760.83 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $1,348.96 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $891.25 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $6,309.57 |
Where Ohio sits
The same service costs 7.2 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 $21,573WA $2,995
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.