How much rates vary
Facilitymedian $2,951 · 10th to 90th $851 to $10,471Professionalmedian $708 · 10th to 90th $95 to $1,122
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 $6,025.60 Typical High $12,589.25 | Facility | None | $1,318.26 | $6,025.60 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $9,120.11 | Professional | None | $724.44 | $977.24 | $9,120.11 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $776.25 Typical High $851.14 | Professional | None | $295.12 | $776.25 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,290.87 Typical High $7,762.47 | Facility | None | $794.33 | $2,290.87 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,445.44 | Professional | None | $630.96 | $776.25 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $3,630.78 | Facility | None | $912.01 | $2,818.38 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $954.99 | Professional | None | $851.14 | $891.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,162.28 Typical High $4,786.30 | Facility | None | $758.58 | $3,162.28 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,513.56 | Professional | None | $645.65 | $933.25 | $1,513.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $3,235.94 Typical High $5,370.32 | Facility | None | $794.33 | $3,235.94 | $5,370.32 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,513.56 | Professional | None | $645.65 | $933.25 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $588.84 Typical High $912.01 | Professional | None | $81.28 | $588.84 | $912.01 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,819.70 | Facility | None | $1,548.82 | $1,621.81 | $1,819.70 |
SummaCare Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,380.38 | Professional | None | $676.08 | $794.33 | $1,380.38 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,120.11 | Facility | None | $851.14 | $2,818.38 | $9,120.11 |
United Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,862.09 | Professional | None | $660.69 | $933.25 | $1,862.09 |
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 $363.08 Median $363.08 Typical High $1,096.48 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $436.52 | Professional | 53 · Discontinued | $144.54 | $144.54 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $1,621.81 | Professional | 54 · Surgery only | $537.03 | $537.03 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $323.59 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $218.78 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $489.78 Typical High $891.25 | Professional | 62 · Two surgeons | $398.11 | $489.78 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $123.03 Typical High $223.87 | Professional | 80 · Assistant surgeon | $100.00 | $123.03 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $107.15 Typical High $199.53 | Professional | AS · PA/NP assist | $87.10 | $107.15 | $199.53 |
Where Ohio sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.