How much rates vary
Facilitymedian $6,166 · 10th to 90th $513 to $22,387Professionalmedian $282 · 10th to 90th $71 to $447
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 $1,202.26 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,202.26 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $2,630.27 | Professional | None | $281.84 | $281.84 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $4,570.88 Typical High $21,877.62 | Facility | None | $616.60 | $4,570.88 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $478.63 | Professional | None | $223.87 | $281.84 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $44.67 Typical High $74.13 | Professional | 80 · Assistant surgeon | $35.48 | $44.67 | $74.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $38.90 Typical High $67.61 | Professional | AS · PA/NP assist | $30.90 | $38.90 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $19,498.45 Typical High $25,118.86 | Facility | None | $389.05 | $19,498.45 | $25,118.86 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $14,125.38 Typical High $28,840.32 | Facility | None | $389.05 | $14,125.38 | $28,840.32 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $562.34 | Professional | None | $323.59 | $398.11 | $562.34 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $14,125.38 Typical High $28,840.32 | Facility | None | $389.05 | $14,125.38 | $28,840.32 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $562.34 | Professional | None | $331.13 | $398.11 | $562.34 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $239.88 Typical High $389.05 | Professional | None | $63.10 | $239.88 | $389.05 |
SummaCare Setting Facility Modifier None Typical Low $13,803.84 Median $14,454.40 Typical High $16,595.87 | Facility | None | $13,803.84 | $14,454.40 | $16,595.87 |
SummaCare Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $416.87 | Professional | None | $288.40 | $316.23 | $416.87 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $22,387.21 | Facility | None | $1,071.52 | $4,265.80 | $22,387.21 |
United Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $562.34 | Professional | None | $194.98 | $323.59 | $562.34 |
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 $141.25 Median $141.25 Typical High $524.81 | Professional | 52 · Reduced service | $141.25 | $141.25 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $208.93 | Professional | 53 · Discontinued | $56.23 | $56.23 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $776.25 | Professional | 54 · Surgery only | $208.93 | $208.93 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $158.49 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $104.71 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $724.44 |
Where Ohio sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.