How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $16,218Professionalmedian $1,047 · 10th to 90th $138 to $1,585
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 $2,691.53 Median $4,073.80 Typical High $12,589.25 | Facility | None | $2,691.53 | $4,073.80 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,122.02 | $4,073.80 |
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 $912.01 Median $1,122.02 Typical High $1,778.28 | Professional | None | $912.01 | $1,122.02 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
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 $1,000.00 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,479.11 | $2,398.83 |
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 $1,000.00 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,479.11 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $891.25 Typical High $1,380.38 | Professional | None | $123.03 | $891.25 | $1,380.38 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,047.13 | $1,621.81 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,380.38 | $2,884.03 |
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 $562.34 Median $562.34 Typical High $2,041.74 | Professional | 52 · Reduced service | $562.34 | $562.34 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $812.83 | Professional | 53 · Discontinued | $223.87 | $223.87 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $3,019.95 | Professional | 54 · Surgery only | $851.14 | $851.14 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $602.56 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $407.38 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $707.95 Typical High $1,122.02 | Professional | 62 · Two surgeons | $575.44 | $707.95 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $177.83 Typical High $281.84 | Professional | 80 · Assistant surgeon | $144.54 | $177.83 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $251.19 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $251.19 |
Where Ohio sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.