How much rates vary
Facilitymedian $2,884 · 10th to 90th $692 to $10,233Professionalmedian $617 · 10th to 90th $447 to $977
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 $977.24 Median $10,232.93 Typical High $13,803.84 | Facility | None | $977.24 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $9,332.54 | Professional | None | $660.69 | $660.69 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $977.24 | Professional | None | $524.81 | $616.60 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $912.01 Typical High $1,412.54 | Professional | 50 · Both sides | $776.25 | $912.01 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $389.05 Typical High $616.60 | Professional | 62 · Two surgeons | $331.13 | $389.05 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $165.96 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $87.10 Typical High $134.90 | Professional | AS · PA/NP assist | $72.44 | $87.10 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,019.95 Typical High $5,248.07 | Facility | None | $549.54 | $3,019.95 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,380.38 | Professional | None | $588.84 | $741.31 | $1,380.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,019.95 Typical High $5,128.61 | Facility | None | $549.54 | $3,019.95 | $5,128.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,380.38 | Professional | None | $588.84 | $741.31 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $776.25 | Professional | None | $363.08 | $575.44 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,949.84 | Facility | None | $1,659.59 | $1,737.80 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,071.52 | Professional | None | $562.34 | $616.60 | $1,071.52 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,737.80 | Professional | None | $630.96 | $794.33 | $1,737.80 |
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 $323.59 Median $323.59 Typical High $891.25 | Professional | 52 · Reduced service | $323.59 | $323.59 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $354.81 | Professional | 53 · Discontinued | $131.83 | $131.83 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $1,348.96 | Professional | 54 · Surgery only | $489.78 | $489.78 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $269.15 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $177.83 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $1,258.93 |
Where Ohio sits
The same service costs 5.6 times more in Wisconsin than in Montana. 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
WI $10,313MT $1,845
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.