How much rates vary
Facilitymedian $1,995 · 10th to 90th $447 to $10,715Professionalmedian $1,096 · 10th to 90th $708 to $1,738
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 $2,454.71 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,454.71 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $9,332.54 | Professional | None | $1,174.90 | $1,174.90 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $2,398.83 Typical High $9,772.37 | Facility | None | $933.25 | $2,398.83 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,698.24 | Professional | None | $933.25 | $1,096.48 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,659.59 Typical High $2,570.40 | Professional | 50 · Both sides | $1,412.54 | $1,659.59 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $295.12 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $239.88 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $239.88 |
Aultcare Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $1,071.52 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,318.26 | $2,570.40 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,318.26 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $1,000.00 Typical High $1,318.26 | Professional | None | $70.79 | $1,000.00 | $1,318.26 |
SummaCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,122.02 | $1,905.46 |
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 $1,122.02 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,584.89 | $3,162.28 |
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 $588.84 Median $588.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $776.25 | Professional | 53 · Discontinued | $234.42 | $234.42 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $2,884.03 | Professional | 54 · Surgery only | $891.25 | $891.25 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $575.44 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $389.05 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $2,691.53 |
Where Ohio sits
The same service costs 7.5 times more in Colorado 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
CO $13,030MD $1,737
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.