How much rates vary
Facilitymedian $2,188 · 10th to 90th $447 to $12,303Professionalmedian $2,570 · 10th to 90th $204 to $4,169
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 $4,570.88 Median $9,332.54 Typical High $12,589.25 | Facility | None | $4,570.88 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $10,232.93 | Professional | None | $3,019.95 | $3,019.95 | $10,232.93 |
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 $2,089.30 Median $2,570.40 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,570.40 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,621.81 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,318.26 | $1,621.81 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $426.58 Typical High $741.31 | Professional | 80 · Assistant surgeon | $331.13 | $426.58 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $363.08 Typical High $616.60 | Professional | AS · PA/NP assist | $288.40 | $363.08 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $2,691.53 Median $3,388.44 Typical High $6,165.95 | Professional | None | $2,691.53 | $3,388.44 | $6,165.95 |
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 $2,691.53 Median $3,388.44 Typical High $6,165.95 | Professional | None | $2,691.53 | $3,388.44 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $2,290.87 Typical High $3,235.94 | Professional | None | $186.21 | $2,290.87 | $3,235.94 |
SummaCare Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $5,011.87 | Professional | None | $2,630.27 | $2,884.03 | $5,011.87 |
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 $2,691.53 Median $3,548.13 Typical High $8,128.31 | Professional | None | $2,691.53 | $3,548.13 | $8,128.31 |
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 $1,513.56 Median $1,513.56 Typical High $4,265.80 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $1,698.24 | Professional | 53 · Discontinued | $602.56 | $602.56 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $6,456.54 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $6,456.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $1,288.25 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $851.14 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,137.96 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,137.96 | $6,025.60 |
Where Ohio sits
The same service costs 6.9 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 $22,987WA $3,314
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.