How much rates vary
Facilitymedian $6,310 · 10th to 90th $692 to $16,596Professionalmedian $1,479 · 10th to 90th $275 to $2,239
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 $1,479.11 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,479.11 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $9,120.11 | Professional | None | $1,479.11 | $1,479.11 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $19,498.45 | Facility | None | $1,047.13 | $7,943.28 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,445.44 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $912.01 Typical High $1,513.56 | Professional | 62 · Two surgeons | $707.95 | $912.01 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $229.09 Typical High $380.19 | Professional | 80 · Assistant surgeon | $177.83 | $229.09 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,862.09 | Facility | None | $891.25 | $1,348.96 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,905.46 | $3,019.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,905.46 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $1,412.54 Typical High $2,041.74 | Professional | None | $239.88 | $1,412.54 | $2,041.74 |
SummaCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,479.11 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,570.88 Typical High $13,803.84 | Facility | None | $1,071.52 | $4,570.88 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,801.89 | Professional | None | $1,348.96 | $1,659.59 | $3,801.89 |
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 $741.31 Median $741.31 Typical High $2,511.89 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $1,000.00 | Professional | 53 · Discontinued | $295.12 | $295.12 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $758.58 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $501.19 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $3,548.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $199.53 Typical High $338.84 | Professional | AS · PA/NP assist | $154.88 | $199.53 | $338.84 |
Where Ohio sits
The same service costs 6.1 times more in Maine than in Kentucky. 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
ME $24,477KY $3,991
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.