How much rates vary
Facilitymedian $2,818 · 10th to 90th $603 to $8,511Professionalmedian $617 · 10th to 90th $87 to $1,023
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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $3,548.13 | Professional | None | $741.31 | $741.31 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $7,585.78 | Facility | None | $588.84 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,202.26 | Professional | None | $549.54 | $691.83 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $3,388.44 Typical High $4,365.16 | Facility | None | $954.99 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $3,467.37 Typical High $5,623.41 | Facility | None | $489.78 | $3,467.37 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,380.38 | Professional | None | $758.58 | $954.99 | $1,380.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $3,467.37 Typical High $5,495.41 | Facility | None | $512.86 | $3,467.37 | $5,495.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,380.38 | Professional | None | $758.58 | $954.99 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $512.86 Typical High $891.25 | Professional | None | $70.79 | $512.86 | $891.25 |
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 $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
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 $478.63 Median $812.83 Typical High $1,380.38 | Professional | None | $478.63 | $812.83 | $1,380.38 |
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 $371.54 Median $371.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $562.34 | Professional | 53 · Discontinued | $147.91 | $147.91 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $2,089.30 | Professional | 54 · Surgery only | $562.34 | $562.34 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $426.58 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $281.84 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,047.13 Typical High $1,778.28 | Professional | 50 · Both sides | $831.76 | $1,047.13 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $436.52 Typical High $758.58 | Professional | 62 · Two surgeons | $346.74 | $436.52 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $120.23 Typical High $549.54 | Professional | 80 · Assistant surgeon | $89.13 | $120.23 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $97.72 Typical High $169.82 | Professional | AS · PA/NP assist | $77.62 | $97.72 | $169.82 |
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· 47th of 51
$646
AK $3,162TX $174
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.