How much rates vary
Facilitymedian $2,399 · 10th to 90th $479 to $7,762Professionalmedian $1,096 · 10th to 90th $138 to $1,622
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 $1,202.26 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,202.26 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,202.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $6,456.54 | Facility | None | $741.31 | $3,311.31 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,548.82 | Professional | None | $851.14 | $1,096.48 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $691.83 Typical High $977.24 | Professional | 62 · Two surgeons | $537.03 | $691.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $173.78 Typical High $251.19 | Professional | 80 · Assistant surgeon | $138.04 | $173.78 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $151.36 Typical High $218.78 | Professional | AS · PA/NP assist | $120.23 | $151.36 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,041.74 | Facility | None | $1,047.13 | $1,513.56 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,288.25 | $1,445.44 |
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 $1,148.15 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,148.15 | $1,288.25 | $1,995.26 |
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 $1,174.90 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,288.25 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $977.24 Typical High $1,513.56 | Professional | None | $97.72 | $977.24 | $1,513.56 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,174.90 | $1,380.38 |
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 $977.24 Median $1,258.93 Typical High $1,949.84 | Professional | None | $977.24 | $1,258.93 | $1,949.84 |
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 $602.56 Median $602.56 Typical High $794.33 | Professional | 52 · Reduced service | $602.56 | $602.56 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,096.48 |
Where Ohio sits
The same service costs 5.9 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 $10,682MD $1,821
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.