How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,047 to $11,220Professionalmedian $871 · 10th to 90th $138 to $1,349
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 $1,659.59 Median $6,760.83 Typical High $15,848.93 | Facility | None | $1,659.59 | $6,760.83 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $8,128.31 | Professional | None | $891.25 | $1,318.26 | $8,128.31 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $9,549.93 | Facility | None | $954.99 | $2,754.23 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,445.44 | Professional | None | $741.31 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $562.34 Typical High $912.01 | Professional | 62 · Two surgeons | $467.74 | $562.34 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $3,630.78 | Facility | None | $1,122.02 | $2,754.23 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,235.94 Typical High $6,025.60 | Facility | None | $1,318.26 | $3,235.94 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,862.09 | Professional | None | $794.33 | $1,148.15 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,318.26 Median $3,235.94 Typical High $6,456.54 | Facility | None | $1,318.26 | $3,235.94 | $6,456.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,862.09 | Professional | None | $794.33 | $1,148.15 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $776.25 Typical High $1,122.02 | Professional | None | $123.03 | $776.25 | $1,122.02 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,698.24 | Professional | None | $831.76 | $870.96 | $1,698.24 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,238.72 | Professional | None | $812.83 | $1,071.52 | $2,238.72 |
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 $436.52 Median $436.52 Typical High $1,995.26 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $794.33 | Professional | 53 · Discontinued | $177.83 | $177.83 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $3,019.95 | Professional | 54 · Surgery only | $660.69 | $660.69 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $602.56 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $398.11 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $2,818.38 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $114.82 | $114.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $141.25 Typical High $229.09 | Professional | 80 · Assistant surgeon | $117.49 | $141.25 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $199.53 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $199.53 |
Where Ohio sits
The same service costs 4.2 times more in Colorado 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
CO $11,551MT $2,762
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.