How much rates vary
Facilitymedian $3,981 · 10th to 90th $501 to $11,482Professionalmedian $1,820 · 10th to 90th $166 to $2,818
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 $3,715.35 Median $7,762.47 Typical High $12,589.25 | Facility | None | $3,715.35 | $7,762.47 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $10,232.93 | Professional | None | $2,290.87 | $2,290.87 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $6,025.60 Typical High $12,589.25 | Facility | None | $1,047.13 | $6,025.60 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,570.40 | Professional | None | $977.24 | $1,230.27 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $1,949.84 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,949.84 | $2,511.89 | $4,466.84 |
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 $2,041.74 Median $2,511.89 Typical High $4,466.84 | Professional | None | $2,041.74 | $2,511.89 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,698.24 Typical High $2,398.83 | Professional | None | $151.36 | $1,698.24 | $2,398.83 |
SummaCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,137.96 | $3,715.35 |
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 $1,949.84 Median $2,630.27 Typical High $6,165.95 | Professional | None | $1,949.84 | $2,630.27 | $6,165.95 |
10 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 $1,148.15 Median $1,148.15 Typical High $3,388.44 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $1,348.96 | Professional | 53 · Discontinued | $467.74 | $467.74 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $5,011.87 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $1,000.00 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $676.08 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,819.70 Typical High $3,890.45 | Professional | 50 · Both sides | $1,479.11 | $1,819.70 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $776.25 Typical High $1,621.81 | Professional | 62 · Two surgeons | $616.60 | $776.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $426.58 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $169.82 Typical High $363.08 | Professional | AS · PA/NP assist | $138.04 | $169.82 | $363.08 |
Where Ohio sits
The same service costs 7.2 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 $19,737WA $2,745
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.