How much rates vary
Facilitymedian $2,570 · 10th to 90th $479 to $10,471Professionalmedian $1,096 · 10th to 90th $813 to $1,738
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 $724.44 Median $2,454.71 Typical High $3,090.30 | Facility | None | $724.44 | $2,454.71 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $2,570.40 | Professional | None | $724.44 | $851.14 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | None | $891.25 | $891.25 | $1,023.29 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 80 · Assistant surgeon | $117.49 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,011.87 Typical High $11,481.54 | Facility | None | $741.31 | $5,011.87 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,819.70 | Professional | None | $954.99 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $776.25 Typical High $1,148.15 | Professional | 62 · Two surgeons | $602.56 | $776.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $199.53 Typical High $288.40 | Professional | 80 · Assistant surgeon | $151.36 | $199.53 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $173.78 Typical High $251.19 | Professional | AS · PA/NP assist | $131.83 | $173.78 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,096.48 | $1,174.90 |
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 $812.83 Median $954.99 Typical High $1,819.70 | Professional | None | $812.83 | $954.99 | $1,819.70 |
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 $169.82 Median $954.99 Typical High $1,819.70 | Professional | None | $169.82 | $954.99 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,380.38 | Professional | None | $812.83 | $1,047.13 | $1,380.38 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,819.70 | Professional | None | $851.14 | $933.25 | $1,819.70 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,737.80 | Professional | None | $851.14 | $1,023.29 | $1,737.80 |
4 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 $1,202.26 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $478.63 | Professional | 53 · Discontinued | $147.91 | $147.91 | $478.63 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $162.18 | $162.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $870.96 Median $977.24 Typical High $1,148.15 | Professional | GC · Resident with teaching physician | $870.96 | $977.24 | $1,148.15 |
Where Ohio sits
The same service costs 10.3 times more in Maine than in Arkansas. 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 $15,629AR $1,524
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.