How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,055Professionalmedian $871 · 10th to 90th $93 to $1,318
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 $870.96 Median $10,232.93 Typical High $13,803.84 | Facility | None | $870.96 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $3,467.37 | Professional | None | $870.96 | $870.96 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $9,549.93 Typical High $22,908.68 | Facility | None | $1,148.15 | $9,549.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,348.96 | Professional | None | $676.08 | $851.14 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $549.54 Typical High $851.14 | Professional | 62 · Two surgeons | $426.58 | $549.54 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $794.33 Median $1,023.29 Typical High $1,778.28 | Professional | None | $794.33 | $1,023.29 | $1,778.28 |
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 $794.33 Median $1,023.29 Typical High $1,778.28 | Professional | None | $794.33 | $1,023.29 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $851.14 Typical High $1,202.26 | Professional | None | $79.43 | $851.14 | $1,202.26 |
SummaCare Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,258.93 | Professional | None | $831.76 | $831.76 | $1,258.93 |
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 $645.65 Median $912.01 Typical High $1,949.84 | Professional | None | $645.65 | $912.01 | $1,949.84 |
8 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 $426.58 Median $426.58 Typical High $1,548.82 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $616.60 | Professional | 53 · Discontinued | $173.78 | $173.78 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $2,344.23 | Professional | 54 · Surgery only | $645.65 | $645.65 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $467.74 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $309.03 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $134.90 Typical High $213.80 | Professional | 80 · Assistant surgeon | $107.15 | $134.90 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $117.49 Typical High $190.55 | Professional | AS · PA/NP assist | $93.33 | $117.49 | $190.55 |
Where Ohio sits
The same service costs 18.1 times more in Maine 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
ME $27,451AR $1,513
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.