How much rates vary
Facilitymedian $1,349 · 10th to 90th $490 to $5,248Professionalmedian $490 · 10th to 90th $363 to $776
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 $891.25 Median $10,232.93 Typical High $13,803.84 | Facility | None | $891.25 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $10,232.93 | Professional | None | $562.34 | $562.34 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $758.58 | Professional | None | $371.54 | $457.09 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $288.40 Typical High $501.19 | Professional | 62 · Two surgeons | $234.42 | $288.40 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $72.44 Typical High $125.89 | Professional | 80 · Assistant surgeon | $60.26 | $72.44 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $63.10 Typical High $107.15 | Professional | AS · PA/NP assist | $52.48 | $63.10 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,691.53 | Facility | None | $549.54 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $1,122.02 | Professional | None | $489.78 | $588.84 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,691.53 | Facility | None | $549.54 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $1,122.02 | Professional | None | $512.86 | $588.84 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $602.56 | Professional | None | $302.00 | $457.09 | $602.56 |
SummaCare Setting Facility Modifier None Typical Low $831.76 Median $870.96 Typical High $1,000.00 | Facility | None | $831.76 | $870.96 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $891.25 | Professional | None | $467.74 | $512.86 | $891.25 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,513.56 | Professional | None | $512.86 | $660.69 | $1,513.56 |
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 $281.84 Median $281.84 Typical High $831.76 | Professional | 52 · Reduced service | $281.84 | $281.84 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $331.13 | Professional | 53 · Discontinued | $114.82 | $114.82 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $1,258.93 | Professional | 54 · Surgery only | $426.58 | $426.58 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $251.19 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $165.96 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $1,174.90 |
Where Ohio sits
The same service costs 4.9 times more in Alaska than in West Virginia. 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 $5,557WV $1,144
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.