How much rates vary
Facilitymedian $2,138 · 10th to 90th $676 to $8,511Professionalmedian $813 · 10th to 90th $135 to $1,349
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 $1,819.70 Median $4,168.69 Typical High $11,220.18 | Facility | None | $1,819.70 | $4,168.69 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $7,079.46 | Professional | None | $1,023.29 | $1,023.29 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $7,585.78 | Facility | None | $645.65 | $1,737.80 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,348.96 | Professional | None | $691.83 | $812.83 | $1,348.96 |
Aultcare Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,995.26 | Facility | None | $1,202.26 | $1,548.82 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,818.38 | Facility | None | $602.56 | $1,862.09 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,513.56 | Professional | None | $741.31 | $1,023.29 | $1,513.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,691.53 | Facility | None | $602.56 | $1,862.09 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $2,041.74 | Professional | None | $741.31 | $1,023.29 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $630.96 Typical High $1,071.52 | Professional | None | $102.33 | $630.96 | $1,071.52 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,071.52 | Professional | None | $912.01 | $954.99 | $1,071.52 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,778.28 | Professional | None | $794.33 | $977.24 | $1,778.28 |
8 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 $512.86 Median $512.86 Typical High $1,584.89 | Professional | 52 · Reduced service | $512.86 | $512.86 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $645.65 | Professional | 53 · Discontinued | $204.17 | $204.17 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $2,398.83 | Professional | 54 · Surgery only | $776.25 | $776.25 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $478.63 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $323.59 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $2,041.74 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $512.86 Typical High $851.14 | Professional | 62 · Two surgeons | $426.58 | $512.86 | $851.14 |
Where Ohio sits
The same service costs 3.4 times more in Alaska than in West Virginia. 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 $8,636WV $2,535
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.