How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $10,233Professionalmedian $2,089 · 10th to 90th $178 to $3,236
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 $2,398.83 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,398.83 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $10,232.93 | Professional | None | $2,398.83 | $2,398.83 | $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 $1,862.09 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,187.76 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,380.38 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,174.90 | $1,380.38 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $354.81 Typical High $549.54 | Professional | 80 · Assistant surgeon | $295.12 | $354.81 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $309.03 Typical High $489.78 | Professional | AS · PA/NP assist | $263.03 | $309.03 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $2,137.96 Median $2,691.53 Typical High $5,011.87 | Professional | None | $2,137.96 | $2,691.53 | $5,011.87 |
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 $2,137.96 Median $2,691.53 Typical High $5,011.87 | Professional | None | $2,137.96 | $2,691.53 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,778.28 Typical High $2,511.89 | Professional | None | $158.49 | $1,778.28 | $2,511.89 |
SummaCare Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,238.72 | $3,890.45 |
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 $2,290.87 Median $2,884.03 Typical High $6,456.54 | Professional | None | $2,290.87 | $2,884.03 | $6,456.54 |
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 $1,202.26 Median $1,202.26 Typical High $3,890.45 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $1,548.82 | Professional | 53 · Discontinued | $478.63 | $478.63 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $5,754.40 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $1,148.15 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $776.25 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $5,370.32 |
Where Ohio sits
The same service costs 7.3 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 $20,260WA $2,785
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.