How much rates vary
Facilitymedian $1,995 · 10th to 90th $794 to $10,233Professionalmedian $562 · 10th to 90th $87 to $933
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 $2,511.89 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,511.89 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $9,120.11 | Professional | None | $691.83 | $691.83 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $7,762.47 | Facility | None | $758.58 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,096.48 | Professional | None | $537.03 | $660.69 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,995.26 | Facility | None | $891.25 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,737.80 Typical High $3,388.44 | Facility | None | $794.33 | $1,737.80 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,288.25 | Professional | None | $707.95 | $891.25 | $1,288.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $1,737.80 Typical High $3,388.44 | Facility | None | $851.14 | $1,737.80 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,288.25 | Professional | None | $707.95 | $891.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $446.68 Typical High $794.33 | Professional | None | $70.79 | $446.68 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $891.25 | Professional | None | $616.60 | $676.08 | $891.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $1,288.25 | Professional | None | $446.68 | $741.31 | $1,288.25 |
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 $346.74 Median $346.74 Typical High $1,174.90 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $467.74 | Professional | 53 · Discontinued | $138.04 | $138.04 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,778.28 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $354.81 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $234.42 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,000.00 Typical High $1,621.81 | Professional | 50 · Both sides | $794.33 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $416.87 Typical High $691.83 | Professional | 62 · Two surgeons | $338.84 | $416.87 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $114.82 Typical High $537.03 | Professional | 80 · Assistant surgeon | $85.11 | $114.82 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $93.33 Typical High $154.88 | Professional | AS · PA/NP assist | $74.13 | $93.33 | $154.88 |
Where Ohio sits
The same service costs 8.7 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
$589
AK $2,951TX $339
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.