How much rates vary
Facilitymedian $1,514 · 10th to 90th $447 to $10,233Professionalmedian $1,230 · 10th to 90th $112 to $1,862
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 $1,380.38 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,380.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $10,232.93 | Professional | None | $1,380.38 | $1,380.38 | $10,232.93 |
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 $1,071.52 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,258.93 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,862.09 Typical High $3,019.95 | Professional | 50 · Both sides | $1,584.89 | $1,862.09 | $3,019.95 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $1,174.90 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,548.82 | $2,818.38 |
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 $1,174.90 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,548.82 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $1,047.13 Typical High $1,445.44 | Professional | None | $97.72 | $1,047.13 | $1,445.44 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,230.27 | $2,137.96 |
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 $1,318.26 Median $1,659.59 Typical High $3,715.35 | Professional | None | $1,318.26 | $1,659.59 | $3,715.35 |
9 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 $691.83 Median $691.83 Typical High $1,949.84 | Professional | 52 · Reduced service | $691.83 | $691.83 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $776.25 | Professional | 53 · Discontinued | $281.84 | $281.84 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $588.84 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $389.05 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $338.84 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $281.84 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $281.84 |
Where Ohio sits
The same service costs 6.4 times more in Alaska 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
AK $12,091MD $1,881
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.