How much rates vary
Facilitymedian $3,467 · 10th to 90th $501 to $11,749Professionalmedian $1,660 · 10th to 90th $166 to $2,512
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 $1,905.46 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,905.46 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $9,332.54 | Professional | None | $1,905.46 | $1,905.46 | $9,332.54 |
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 $1,318.26 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,659.59 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,698.24 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,137.96 | $3,801.89 |
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 $1,698.24 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,137.96 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,412.54 Typical High $1,995.26 | Professional | None | $151.36 | $1,412.54 | $1,995.26 |
SummaCare Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,778.28 | $3,090.30 |
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 $1,778.28 Median $2,290.87 Typical High $5,128.61 | Professional | None | $1,778.28 | $2,290.87 | $5,128.61 |
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 $954.99 Median $954.99 Typical High $3,019.95 | Professional | 52 · Reduced service | $954.99 | $954.99 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $1,202.26 | Professional | 53 · Discontinued | $380.19 | $380.19 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $4,466.84 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $891.25 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $602.56 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,511.89 Typical High $3,801.89 | Professional | 50 · Both sides | $1,819.70 | $2,511.89 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,047.13 Typical High $1,621.81 | Professional | 62 · Two surgeons | $812.83 | $1,047.13 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $269.15 Typical High $407.38 | Professional | 80 · Assistant surgeon | $208.93 | $269.15 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $234.42 Typical High $363.08 | Professional | AS · PA/NP assist | $177.83 | $234.42 | $363.08 |
Where Ohio sits
The same service costs 7.9 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 $19,273WA $2,428
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.