How much rates vary
Facilitymedian $2,042 · 10th to 90th $447 to $12,589Professionalmedian $1,820 · 10th to 90th $166 to $2,884
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 $2,691.53 Median $9,332.54 Typical High $12,589.25 | Facility | None | $2,691.53 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $9,120.11 | Professional | None | $2,041.74 | $2,041.74 | $9,120.11 |
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 $1,548.82 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,862.09 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,174.90 Typical High $1,995.26 | Professional | 62 · Two surgeons | $954.99 | $1,174.90 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $309.03 Typical High $549.54 | Professional | 80 · Assistant surgeon | $245.47 | $309.03 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $263.03 Typical High $457.09 | Professional | AS · PA/NP assist | $213.80 | $263.03 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $1,819.70 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,819.70 | $2,238.72 | $4,073.80 |
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 $1,819.70 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,819.70 | $2,238.72 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,548.82 Typical High $2,187.76 | Professional | None | $151.36 | $1,548.82 | $2,187.76 |
SummaCare Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,778.28 | $1,949.84 | $3,388.44 |
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 $1,905.46 Median $2,398.83 Typical High $5,495.41 | Professional | None | $1,905.46 | $2,398.83 | $5,495.41 |
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 $1,023.29 Median $1,023.29 Typical High $3,019.95 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $1,202.26 | Professional | 53 · Discontinued | $407.38 | $407.38 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $912.01 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $602.56 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $4,265.80 |
Where Ohio sits
The same service costs 7.9 times more in Alabama 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
AL $20,238WA $2,549
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.