How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $9,333Professionalmedian $646 · 10th to 90th $457 to $977
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 $6,606.93 Typical High $12,589.25 | Facility | None | $1,737.80 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $8,709.64 | Professional | None | $630.96 | $630.96 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $2,630.27 Typical High $8,128.31 | Facility | None | $776.25 | $2,630.27 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,000.00 | Professional | None | $501.19 | $602.56 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $380.19 Typical High $630.96 | Professional | 62 · Two surgeons | $316.23 | $380.19 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $95.50 Typical High $162.18 | Professional | 80 · Assistant surgeon | $79.43 | $95.50 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $2,754.23 Typical High $3,630.78 | Facility | None | $794.33 | $2,754.23 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,951.21 Typical High $4,897.79 | Facility | None | $741.31 | $2,951.21 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,288.25 | Professional | None | $562.34 | $691.83 | $1,288.25 |
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 $562.34 Median $691.83 Typical High $1,288.25 | Professional | None | $562.34 | $691.83 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $645.65 Typical High $870.96 | Professional | None | $57.54 | $645.65 | $870.96 |
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 $588.84 Median $588.84 Typical High $912.01 | Professional | None | $588.84 | $588.84 | $912.01 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,513.56 | Professional | None | $602.56 | $741.31 | $1,513.56 |
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 $1,230.27 | Professional | 52 · Reduced service | $316.23 | $316.23 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $489.78 | Professional | 53 · Discontinued | $125.89 | $125.89 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $1,819.70 | Professional | 54 · Surgery only | $478.63 | $478.63 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $371.54 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $245.47 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $83.18 Typical High $138.04 | Professional | AS · PA/NP assist | $69.18 | $83.18 | $138.04 |
Where Ohio sits
The same service costs 5.1 times more in Wisconsin 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
WI $10,170MT $2,000
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.