How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $10,965Professionalmedian $759 · 10th to 90th $89 to $1,288
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 $3,467.37 Median $10,000.00 Typical High $13,803.84 | Facility | None | $3,467.37 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $8,317.64 | Professional | None | $977.24 | $977.24 | $8,317.64 |
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 $691.83 Median $870.96 Typical High $1,412.54 | Professional | None | $691.83 | $870.96 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,398.83 | Facility | None | $1,230.27 | $1,621.81 | $2,398.83 |
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 $977.24 Median $1,288.25 Typical High $1,862.09 | Professional | None | $977.24 | $1,288.25 | $1,862.09 |
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 $977.24 Median $1,288.25 Typical High $1,778.28 | Professional | None | $977.24 | $1,288.25 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $616.60 Typical High $1,071.52 | Professional | None | $70.79 | $616.60 | $1,071.52 |
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 $831.76 Median $912.01 Typical High $1,202.26 | Professional | None | $831.76 | $912.01 | $1,202.26 |
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 $630.96 Median $1,047.13 Typical High $1,819.70 | Professional | None | $630.96 | $1,047.13 | $1,819.70 |
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 $489.78 Median $489.78 Typical High $1,621.81 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $645.65 | Professional | 53 · Discontinued | $194.98 | $194.98 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $2,454.71 | Professional | 54 · Surgery only | $724.44 | $724.44 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $489.78 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $323.59 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,318.26 Typical High $2,137.96 | Professional | 50 · Both sides | $1,047.13 | $1,318.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $549.54 Typical High $891.25 | Professional | 62 · Two surgeons | $436.52 | $549.54 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $141.25 Typical High $229.09 | Professional | 80 · Assistant surgeon | $112.20 | $141.25 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $123.03 Typical High $199.53 | Professional | AS · PA/NP assist | $97.72 | $123.03 | $199.53 |
Where Ohio sits
The same service costs 18.2 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
$776
AK $4,074TX $224
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.