How much rates vary
Facilitymedian $3,020 · 10th to 90th $794 to $9,550Professionalmedian $589 · 10th to 90th $91 to $871
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 $1,737.80 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,737.80 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $2,137.96 | Professional | None | $630.96 | $630.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,630.27 Typical High $7,762.47 | Facility | None | $794.33 | $2,630.27 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $851.14 | Professional | None | $501.19 | $588.84 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $371.54 Typical High $537.03 | Professional | 62 · Two surgeons | $316.23 | $371.54 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $93.33 Typical High $138.04 | Professional | 80 · Assistant surgeon | $79.43 | $93.33 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | None | $676.08 | $676.08 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,951.21 Typical High $4,897.79 | Facility | None | $691.83 | $2,951.21 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,071.52 | Professional | None | $616.60 | $676.08 | $1,071.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $4,570.88 | Facility | None | $741.31 | $3,019.95 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,071.52 | Professional | None | $616.60 | $676.08 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $512.86 Typical High $812.83 | Professional | None | $64.57 | $512.86 | $812.83 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,047.13 | Professional | None | $524.81 | $676.08 | $1,047.13 |
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 $316.23 Median $316.23 Typical High $416.87 | Professional | 52 · Reduced service | $316.23 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $630.96 | Professional | 54 · Surgery only | $478.63 | $478.63 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $125.89 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $83.18 Typical High $125.89 | Professional | AS · PA/NP assist | $70.79 | $83.18 | $125.89 |
Where Ohio sits
The same service costs 5.4 times more in Colorado than in Montana. 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 $11,084MT $2,070
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.