How much rates vary
Facilitymedian $1,820 · 10th to 90th $741 to $9,333Professionalmedian $550 · 10th to 90th $93 to $891
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 $1,047.13 Median $6,025.60 Typical High $12,589.25 | Facility | None | $1,047.13 | $6,025.60 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $9,120.11 | Professional | None | $562.34 | $758.58 | $9,120.11 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $4,786.30 | Facility | None | $645.65 | $1,202.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $870.96 | Professional | None | $407.38 | $489.78 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $309.03 Typical High $549.54 | Professional | 62 · Two surgeons | $257.04 | $309.03 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,621.81 Typical High $2,089.30 | Facility | None | $707.95 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $3,388.44 | Facility | None | $794.33 | $1,862.09 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,122.02 | Professional | None | $524.81 | $691.83 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $3,548.13 | Facility | None | $851.14 | $1,862.09 | $3,548.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,148.15 | Professional | None | $524.81 | $691.83 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $776.25 | Professional | None | $79.43 | $524.81 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | None | $549.54 | $549.54 | $776.25 |
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 $489.78 Median $616.60 Typical High $1,445.44 | Professional | None | $489.78 | $616.60 | $1,445.44 |
8 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 $281.84 Median $281.84 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $77.62 Typical High $138.04 | Professional | 80 · Assistant surgeon | $66.07 | $77.62 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $67.61 Typical High $120.23 | Professional | AS · PA/NP assist | $57.54 | $67.61 | $120.23 |
Where Ohio sits
The same service costs 3.6 times more in Oklahoma 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
OK $6,446MT $1,806
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.