How much rates vary
Facilitymedian $3,802 · 10th to 90th $851 to $11,220Professionalmedian $646 · 10th to 90th $87 to $1,047
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 $776.25 Median $776.25 Typical High $6,309.57 | Professional | None | $776.25 | $776.25 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $3,467.37 Typical High $12,022.64 | Facility | None | $912.01 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,230.27 | Professional | None | $602.56 | $741.31 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,000.00 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,630.78 Typical High $5,888.44 | Facility | None | $794.33 | $3,630.78 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,445.44 | Professional | None | $794.33 | $1,000.00 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $3,630.78 Typical High $5,623.41 | Facility | None | $851.14 | $3,630.78 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,445.44 | Professional | None | $794.33 | $1,000.00 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $524.81 Typical High $912.01 | Professional | None | $70.79 | $524.81 | $912.01 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $977.24 | Professional | None | $691.83 | $758.58 | $977.24 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,445.44 | Professional | None | $501.19 | $831.76 | $1,445.44 |
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 $389.05 Median $389.05 Typical High $1,318.26 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $524.81 | Professional | 53 · Discontinued | $154.88 | $154.88 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $389.05 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $263.03 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,122.02 Typical High $1,862.09 | Professional | 50 · Both sides | $891.25 | $1,122.02 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $467.74 Typical High $776.25 | Professional | 62 · Two surgeons | $371.54 | $467.74 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $128.82 Typical High $602.56 | Professional | 80 · Assistant surgeon | $95.50 | $128.82 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $104.71 Typical High $173.78 | Professional | AS · PA/NP assist | $83.18 | $104.71 | $173.78 |
Where Ohio sits
The same service costs 7.4 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· 47th of 51
$676
AK $3,311TX $447
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.