How much rates vary
Facilitymedian $2,754 · 10th to 90th $813 to $10,233Professionalmedian $912 · 10th to 90th $93 to $1,349
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 $3,019.95 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,019.95 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $10,232.93 | Professional | None | $912.01 | $912.01 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,187.76 Typical High $7,762.47 | Facility | None | $794.33 | $2,187.76 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,445.44 | Professional | None | $724.44 | $870.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $549.54 Typical High $912.01 | Professional | 62 · Two surgeons | $457.09 | $549.54 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $141.25 Typical High $234.42 | Professional | 80 · Assistant surgeon | $114.82 | $141.25 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $204.17 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $2,454.71 Typical High $3,162.28 | Facility | None | $1,148.15 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,884.03 Typical High $4,365.16 | Facility | None | $794.33 | $2,884.03 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,905.46 | Professional | None | $812.83 | $1,023.29 | $1,905.46 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $2,884.03 Typical High $4,168.69 | Facility | None | $851.14 | $2,884.03 | $4,168.69 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,905.46 | Professional | None | $812.83 | $1,023.29 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,230.27 | Professional | None | $79.43 | $870.96 | $1,230.27 |
SummaCare Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,412.54 | $1,479.11 | $1,659.59 |
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 $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,238.72 | Professional | None | $891.25 | $1,071.52 | $2,238.72 |
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 $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 $186.21 Median $186.21 Typical High $616.60 | Professional | 53 · Discontinued | $186.21 | $186.21 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,290.87 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $457.09 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $457.09 |
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 $2,137.96 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $2,137.96 |
Where Ohio sits
The same service costs 4.1 times more in Alaska than in Delaware. 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
AK $9,881DE $2,434
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.