How much rates vary
Facilitymedian $7,079 · 10th to 90th $871 to $22,909Professionalmedian $1,202 · 10th to 90th $174 to $1,950
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 $3,235.94 Median $7,079.46 Typical High $12,022.64 | Facility | None | $3,235.94 | $7,079.46 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $8,511.38 | Professional | None | $1,174.90 | $1,202.26 | $8,511.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $12,022.64 Typical High $28,183.83 | Facility | None | $1,479.11 | $12,022.64 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,318.26 | $2,137.96 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,174.90 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,698.24 | $2,818.38 |
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 $1,174.90 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,698.24 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,047.13 Typical High $1,698.24 | Professional | None | $158.49 | $1,047.13 | $1,698.24 |
SummaCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,230.27 | $1,862.09 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $10,471.29 | Facility | None | $912.01 | $3,388.44 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,737.80 | $3,162.28 |
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 $588.84 Median $588.84 Typical High $3,235.94 | Professional | 52 · Reduced service | $588.84 | $588.84 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $1,288.25 | Professional | 53 · Discontinued | $234.42 | $234.42 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $4,897.79 | Professional | 54 · Surgery only | $870.96 | $870.96 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $977.24 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $645.65 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,348.96 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $363.08 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $186.21 Typical High $302.00 | Professional | AS · PA/NP assist | $144.54 | $186.21 | $302.00 |
Where Ohio sits
The same service costs 13.5 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 $34,179TX $2,531
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.