How much rates vary
Facilitymedian $2,818 · 10th to 90th $692 to $10,233Professionalmedian $933 · 10th to 90th $135 to $1,585
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 $10,232.93 Typical High $13,803.84 | Facility | None | $1,202.26 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $7,943.28 | Professional | None | $1,202.26 | $1,202.26 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,819.70 | Professional | None | $851.14 | $1,071.52 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,630.78 Typical High $6,165.95 | Facility | None | $549.54 | $3,630.78 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,584.89 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,630.78 Typical High $5,888.44 | Facility | None | $549.54 | $3,630.78 | $5,888.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,584.89 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $758.58 Typical High $1,318.26 | Professional | None | $107.15 | $758.58 | $1,318.26 |
SummaCare Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,398.83 | Facility | None | $1,995.26 | $2,089.30 | $2,398.83 |
SummaCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,122.02 | $1,479.11 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $2,238.72 | Professional | None | $776.25 | $1,258.93 | $2,238.72 |
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 $602.56 Median $602.56 Typical High $3,630.78 | Professional | 52 · Reduced service | $602.56 | $602.56 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $1,445.44 | Professional | 53 · Discontinued | $239.88 | $239.88 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $5,495.41 | Professional | 54 · Surgery only | $891.25 | $891.25 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $1,096.48 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $724.44 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,584.89 Typical High $2,691.53 | Professional | 50 · Both sides | $1,288.25 | $1,584.89 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $676.08 Typical High $1,122.02 | Professional | 62 · Two surgeons | $537.03 | $676.08 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $186.21 Typical High $851.14 | Professional | 80 · Assistant surgeon | $134.90 | $186.21 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $147.91 Typical High $251.19 | Professional | AS · PA/NP assist | $120.23 | $147.91 | $251.19 |
Where Ohio sits
The same service costs 16.2 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· 48th of 51
$955
AK $5,012TX $309
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.