How much rates vary
Facilitymedian $1,479 · 10th to 90th $490 to $6,166Professionalmedian $1,096 · 10th to 90th $83 to $1,660
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 $1,230.27 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,230.27 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $10,232.93 | Professional | None | $1,230.27 | $1,230.27 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $3,801.89 | Facility | None | $794.33 | $1,584.89 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,737.80 | Professional | None | $851.14 | $1,023.29 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $645.65 Typical High $1,096.48 | Professional | 62 · Two surgeons | $549.54 | $645.65 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $281.84 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
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 $1,122.02 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,318.26 | $2,290.87 |
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 $1,122.02 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,348.96 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $977.24 Typical High $1,380.38 | Professional | None | $77.62 | $977.24 | $1,380.38 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,202.26 | $2,089.30 |
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 $1,122.02 Median $1,445.44 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,445.44 | $3,311.31 |
7 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 $616.60 Median $616.60 Typical High $1,698.24 | Professional | 52 · Reduced service | $616.60 | $616.60 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $676.08 | Professional | 53 · Discontinued | $251.19 | $251.19 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $2,511.89 | Professional | 54 · Surgery only | $933.25 | $933.25 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $501.19 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $338.84 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $2,344.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $245.47 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $245.47 |
Where Ohio sits
The same service costs 9.9 times more in Alabama 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
AL $18,241MD $1,851
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.