How much rates vary
Facilitymedian $6,026 · 10th to 90th $631 to $26,915Professionalmedian $407 · 10th to 90th $245 to $631
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 $645.65 Median $3,548.13 Typical High $12,589.25 | Facility | None | $645.65 | $3,548.13 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $3,548.13 | Professional | None | $346.74 | $398.11 | $3,548.13 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $5,011.87 Typical High $29,512.09 | Facility | None | $776.25 | $5,011.87 | $29,512.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $724.44 | Professional | None | $407.38 | $501.19 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $316.23 Typical High $467.74 | Professional | 62 · Two surgeons | $257.04 | $316.23 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $14,125.38 Typical High $18,197.01 | Facility | None | $478.63 | $14,125.38 | $18,197.01 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $15,848.93 Typical High $27,542.29 | Facility | None | $489.78 | $15,848.93 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $741.31 | Professional | None | $398.11 | $489.78 | $741.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $15,848.93 Typical High $27,542.29 | Facility | None | $512.86 | $15,848.93 | $27,542.29 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $741.31 | Professional | None | $398.11 | $489.78 | $741.31 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $316.23 Typical High $478.63 | Professional | None | $43.65 | $316.23 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $7,943.28 Median $8,317.64 Typical High $9,549.93 | Facility | None | $7,943.28 | $8,317.64 | $9,549.93 |
SummaCare Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $489.78 | Professional | None | $338.84 | $380.19 | $489.78 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $7,244.36 Typical High $25,118.86 | Facility | None | $1,258.93 | $7,244.36 | $25,118.86 |
United Setting Professional Modifier None Typical Low $239.88 Median $436.52 Typical High $741.31 | Professional | None | $239.88 | $436.52 | $741.31 |
6 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 $173.78 Median $173.78 Typical High $1,348.96 | Professional | 52 · Reduced service | $173.78 | $173.78 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $549.54 | Professional | 53 · Discontinued | $69.18 | $69.18 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $2,041.74 | Professional | 54 · Surgery only | $257.04 | $257.04 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $407.38 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $275.42 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $1,905.46 |
Where Ohio sits
The same service costs 29.4 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 $37,066MT $1,262
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.