How much rates vary
Facilitymedian $1,479 · 10th to 90th $479 to $6,166Professionalmedian $398 · 10th to 90th $295 to $631
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 $660.69 Median $10,232.93 Typical High $13,803.84 | Facility | None | $660.69 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $9,332.54 | Professional | None | $436.52 | $436.52 | $9,332.54 |
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 $309.03 Median $380.19 Typical High $616.60 | Professional | None | $309.03 | $380.19 | $616.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $239.88 Typical High $389.05 | Professional | 62 · Two surgeons | $194.98 | $239.88 | $389.05 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $60.26 Typical High $100.00 | Professional | 80 · Assistant surgeon | $48.98 | $60.26 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $51.29 Typical High $85.11 | Professional | AS · PA/NP assist | $42.66 | $51.29 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
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 $389.05 Median $446.68 Typical High $794.33 | Professional | None | $389.05 | $446.68 | $794.33 |
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 $389.05 Median $467.74 Typical High $851.14 | Professional | None | $389.05 | $467.74 | $851.14 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $371.54 Typical High $489.78 | Professional | None | $44.67 | $371.54 | $489.78 |
SummaCare Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $707.95 | Professional | None | $380.19 | $416.87 | $707.95 |
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 $398.11 Median $501.19 Typical High $1,174.90 | Professional | None | $398.11 | $501.19 | $1,174.90 |
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 $213.80 Median $213.80 Typical High $707.95 | Professional | 52 · Reduced service | $213.80 | $213.80 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $281.84 | Professional | 53 · Discontinued | $87.10 | $87.10 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $1,047.13 | Professional | 54 · Surgery only | $323.59 | $323.59 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $213.80 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $141.25 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $977.24 |
Where Ohio sits
The same service costs 6.7 times more in Colorado than in Arkansas. 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 $6,451AR $969
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.