How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $10,965Professionalmedian $589 · 10th to 90th $89 to $977
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 $2,691.53 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,691.53 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $9,120.11 | Professional | None | $741.31 | $741.31 | $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 $549.54 Median $691.83 Typical High $1,122.02 | Professional | None | $549.54 | $691.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $117.49 Typical High $549.54 | Professional | 80 · Assistant surgeon | $89.13 | $117.49 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,737.80 | Facility | None | $891.25 | $1,174.90 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $5,011.87 | Facility | None | $588.84 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,380.38 | Professional | None | $741.31 | $977.24 | $1,380.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $4,897.79 | Facility | None | $588.84 | $2,951.21 | $4,897.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,318.26 | Professional | None | $741.31 | $977.24 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $467.74 Typical High $831.76 | Professional | None | $70.79 | $467.74 | $831.76 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $933.25 | Professional | None | $645.65 | $707.95 | $933.25 |
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 $489.78 Median $812.83 Typical High $1,412.54 | Professional | None | $489.78 | $812.83 | $1,412.54 |
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 $371.54 Median $371.54 Typical High $1,348.96 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $537.03 | Professional | 53 · Discontinued | $147.91 | $147.91 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $1,995.26 | Professional | 54 · Surgery only | $549.54 | $549.54 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $407.38 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $269.15 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,047.13 Typical High $1,659.59 | Professional | 50 · Both sides | $831.76 | $1,047.13 | $1,659.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $97.72 Typical High $158.49 | Professional | AS · PA/NP assist | $77.62 | $97.72 | $158.49 |
Where Ohio sits
The same service costs 16.6 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
$603
AK $3,090TX $186
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.