How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,000 to $17,378Professionalmedian $2,512 · 10th to 90th $380 to $4,169
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 $3,162.28 Median $10,471.29 Typical High $13,803.84 | Facility | None | $3,162.28 | $10,471.29 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $10,471.29 | Professional | None | $3,162.28 | $3,162.28 | $10,471.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,467.37 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $5,623.41 | Professional | None | $2,511.89 | $3,090.30 | $5,623.41 |
CareSource Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $13,489.63 Typical High $21,379.62 | Facility | None | $588.84 | $13,489.63 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $4,168.69 Typical High $6,025.60 | Professional | None | $3,235.94 | $4,168.69 | $6,025.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $13,489.63 Typical High $20,892.96 | Facility | None | $588.84 | $13,489.63 | $20,892.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3,235.94 Median $4,168.69 Typical High $6,025.60 | Professional | None | $3,235.94 | $4,168.69 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $1,949.84 Typical High $3,467.37 | Professional | None | $323.59 | $1,949.84 | $3,467.37 |
SummaCare Setting Facility Modifier None Typical Low $14,454.40 Median $15,135.61 Typical High $16,982.44 | Facility | None | $14,454.40 | $15,135.61 | $16,982.44 |
SummaCare Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,691.53 | $2,951.21 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $5,888.44 | Professional | None | $2,041.74 | $3,388.44 | $5,888.44 |
10 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 $1,584.89 Median $1,584.89 Typical High $4,897.79 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $1,949.84 | Professional | 53 · Discontinued | $630.96 | $630.96 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $7,244.36 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $1,479.11 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $977.24 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $4,677.35 Typical High $8,317.64 | Professional | 50 · Both sides | $3,715.35 | $4,677.35 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,949.84 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,548.82 | $1,949.84 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $537.03 Typical High $2,511.89 | Professional | 80 · Assistant surgeon | $398.11 | $537.03 | $2,511.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $436.52 Typical High $776.25 | Professional | AS · PA/NP assist | $346.74 | $436.52 | $776.25 |
Where Ohio sits
The same service costs 20.4 times more in Alaska 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.
Ohio· 47th of 51
$2,512
AK $13,183TX $646
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.