How much rates vary
Facilitymedian $1,660 · 10th to 90th $447 to $12,589Professionalmedian $617 · 10th to 90th $447 to $1,148
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 $741.31 Median $10,232.93 Typical High $13,803.84 | Facility | None | $741.31 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $10,232.93 | Professional | None | $501.19 | $501.19 | $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 $467.74 Median $645.65 Typical High $977.24 | Professional | None | $467.74 | $645.65 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $102.33 Typical High $154.88 | Professional | 80 · Assistant surgeon | $74.13 | $102.33 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $89.13 Typical High $134.90 | Professional | AS · PA/NP assist | $64.57 | $89.13 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
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 $467.74 Median $676.08 Typical High $1,380.38 | Professional | None | $467.74 | $676.08 | $1,380.38 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,380.38 | Professional | None | $489.78 | $676.08 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $630.96 | Professional | None | $416.87 | $512.86 | $630.96 |
SummaCare Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $954.99 | Professional | None | $436.52 | $467.74 | $954.99 |
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 $588.84 Median $933.25 Typical High $1,348.96 | Professional | None | $588.84 | $933.25 | $1,348.96 |
5 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 $251.19 Median $251.19 Typical High $1,000.00 | Professional | 52 · Reduced service | $251.19 | $251.19 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $398.11 | Professional | 53 · Discontinued | $100.00 | $100.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $1,513.56 | Professional | 54 · Surgery only | $371.54 | $371.54 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $302.00 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $199.53 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $199.53 |
Where Ohio sits
The same service costs 13.6 times more in Colorado than in Maryland. 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
CO $15,162MD $1,112
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.