How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $10,965Professionalmedian $955 · 10th to 90th $135 to $1,622
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 $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $9,120.11 | Professional | None | $1,230.27 | $1,230.27 | $9,120.11 |
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 $912.01 Median $1,122.02 Typical High $1,819.70 | Professional | None | $912.01 | $1,122.02 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,715.35 Typical High $6,165.95 | Facility | None | $588.84 | $3,715.35 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,621.81 | $2,238.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $3,801.89 Typical High $5,754.40 | Facility | None | $588.84 | $3,801.89 | $5,754.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,621.81 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $794.33 Typical High $1,348.96 | Professional | None | $107.15 | $794.33 | $1,348.96 |
SummaCare Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,344.23 | Facility | None | $1,995.26 | $2,089.30 | $2,344.23 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,148.15 | $1,513.56 |
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 $794.33 Median $1,348.96 Typical High $2,290.87 | Professional | None | $794.33 | $1,348.96 | $2,290.87 |
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 $616.60 Median $616.60 Typical High $2,187.76 | Professional | 52 · Reduced service | $616.60 | $616.60 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $870.96 | Professional | 53 · Discontinued | $245.47 | $245.47 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $3,235.94 | Professional | 54 · Surgery only | $912.01 | $912.01 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $645.65 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $436.52 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,754.23 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $707.95 Typical High $1,148.15 | Professional | 62 · Two surgeons | $562.34 | $707.95 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $181.97 Typical High $288.40 | Professional | 80 · Assistant surgeon | $144.54 | $181.97 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $257.04 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $257.04 |
Where Ohio sits
The same service costs 17.8 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
$977
AK $5,129TX $288
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.