How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $1,622 · 10th to 90th $214 to $2,570
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 $1,737.80 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,737.80 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $8,912.51 | Professional | None | $1,737.80 | $1,737.80 | $8,912.51 |
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 $1,380.38 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,737.80 | $2,951.21 |
CareSource Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,511.89 | $3,467.37 |
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 $1,949.84 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,511.89 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,348.96 Typical High $2,238.72 | Professional | None | $199.53 | $1,348.96 | $2,238.72 |
SummaCare Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,862.09 | $2,454.71 |
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 $1,202.26 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,202.26 | $1,995.26 | $3,548.13 |
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 $870.96 Median $870.96 Typical High $3,890.45 | Professional | 52 · Reduced service | $870.96 | $870.96 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $1,548.82 | Professional | 53 · Discontinued | $354.81 | $354.81 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $5,754.40 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $1,148.15 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $776.25 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,096.48 Typical High $1,862.09 | Professional | 62 · Two surgeons | $870.96 | $1,096.48 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $275.42 Typical High $467.74 | Professional | 80 · Assistant surgeon | $223.87 | $275.42 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $245.47 Typical High $407.38 | Professional | AS · PA/NP assist | $194.98 | $245.47 | $407.38 |
Where Ohio sits
The same service costs 14.0 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 $34,704TX $2,477
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.