How much rates vary
Facilitymedian $3,802 · 10th to 90th $851 to $11,220Professionalmedian $550 · 10th to 90th $87 to $912
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 $2,454.71 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,454.71 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $6,309.57 | Professional | None | $660.69 | $660.69 | $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 $501.19 Median $616.60 Typical High $1,071.52 | Professional | None | $501.19 | $616.60 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $109.65 Typical High $501.19 | Professional | 80 · Assistant surgeon | $79.43 | $109.65 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,365.16 | Facility | None | $851.14 | $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 $676.08 Median $851.14 Typical High $1,230.27 | Professional | None | $676.08 | $851.14 | $1,230.27 |
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 $676.08 Median $851.14 Typical High $1,258.93 | Professional | None | $676.08 | $851.14 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $446.68 Typical High $758.58 | Professional | None | $70.79 | $446.68 | $758.58 |
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 $588.84 Median $645.65 Typical High $851.14 | Professional | None | $588.84 | $645.65 | $851.14 |
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 $426.58 Median $707.95 Typical High $1,230.27 | Professional | None | $426.58 | $707.95 | $1,230.27 |
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 $331.13 Median $331.13 Typical High $1,122.02 | Professional | 52 · Reduced service | $331.13 | $331.13 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $446.68 | Professional | 53 · Discontinued | $131.83 | $131.83 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $1,698.24 | Professional | 54 · Surgery only | $501.19 | $501.19 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $338.84 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $223.87 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $933.25 Typical High $1,584.89 | Professional | 50 · Both sides | $741.31 | $933.25 | $1,584.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $87.10 Typical High $151.36 | Professional | AS · PA/NP assist | $69.18 | $87.10 | $151.36 |
Where Ohio sits
The same service costs 7.8 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· 47th of 51
$575
AK $2,818TX $363
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.