How much rates vary
Facilitymedian $3,548 · 10th to 90th $851 to $10,965Professionalmedian $891 · 10th to 90th $79 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 $2,511.89 Median $9,120.11 Typical High $12,589.25 | Facility | None | $2,511.89 | $9,120.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $9,772.37 | Professional | None | $912.01 | $912.01 | $9,772.37 |
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 $724.44 Median $851.14 Typical High $1,412.54 | Professional | None | $724.44 | $851.14 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,786.30 Typical High $7,762.47 | Facility | None | $794.33 | $4,786.30 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,862.09 | Professional | None | $812.83 | $1,000.00 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $4,897.79 Typical High $7,585.78 | Facility | None | $794.33 | $4,897.79 | $7,585.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,862.09 | Professional | None | $812.83 | $1,000.00 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $831.76 Typical High $1,202.26 | Professional | None | $63.10 | $831.76 | $1,202.26 |
SummaCare Setting Facility Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $3,162.28 | Facility | None | $2,630.27 | $2,754.23 | $3,162.28 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,318.26 | Professional | None | $851.14 | $851.14 | $1,318.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $10,232.93 | Facility | None | $851.14 | $2,754.23 | $10,232.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,187.76 | Professional | None | $870.96 | $1,071.52 | $2,187.76 |
10 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 $457.09 Median $457.09 Typical High $1,548.82 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $616.60 | Professional | 53 · Discontinued | $181.97 | $181.97 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,344.23 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $467.74 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $309.03 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,288.25 Typical High $2,041.74 | Professional | 50 · Both sides | $1,071.52 | $1,288.25 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $870.96 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $223.87 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $194.98 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $194.98 |
Where Ohio sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.