How much rates vary
Facilitymedian $2,138 · 10th to 90th $631 to $7,762Professionalmedian $468 · 10th to 90th $93 to $724
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 $1,318.26 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,318.26 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $7,762.47 | Professional | None | $489.78 | $489.78 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,230.27 Typical High $4,786.30 | Facility | None | $562.34 | $1,230.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $794.33 | Professional | None | $363.08 | $467.74 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $2,137.96 Typical High $2,818.38 | Facility | None | $616.60 | $2,137.96 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,715.35 | Facility | None | $602.56 | $2,398.83 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,023.29 | Professional | None | $446.68 | $630.96 | $1,023.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,467.37 | Facility | None | $602.56 | $2,398.83 | $3,467.37 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,023.29 | Professional | None | $446.68 | $630.96 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $616.60 | Professional | None | $79.43 | $426.58 | $616.60 |
SummaCare Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,174.90 | $1,230.27 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Professional | None | $467.74 | $467.74 | $691.83 |
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 $446.68 Median $562.34 Typical High $1,258.93 | Professional | None | $446.68 | $562.34 | $1,258.93 |
9 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 $245.47 Median $245.47 Typical High $323.59 | Professional | 52 · Reduced service | $245.47 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $457.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $229.09 Median $295.12 Typical High $501.19 | Professional | 62 · Two surgeons | $229.09 | $295.12 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $75.86 Typical High $128.82 | Professional | 80 · Assistant surgeon | $58.88 | $75.86 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $66.07 Typical High $112.20 | Professional | AS · PA/NP assist | $51.29 | $66.07 | $112.20 |
Where Ohio sits
The same service costs 5.0 times more in Alaska than in West Virginia. 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 $7,101WV $1,411
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.