How much rates vary
Facilitymedian $3,802 · 10th to 90th $759 to $10,965Professionalmedian $692 · 10th to 90th $89 to $1,122
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $5,754.40 | Professional | None | $831.76 | $831.76 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $3,467.37 Typical High $12,022.64 | Facility | None | $831.76 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,288.25 | Professional | None | $630.96 | $776.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $134.90 Typical High $630.96 | Professional | 80 · Assistant surgeon | $100.00 | $134.90 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,071.52 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,888.44 | Facility | None | $602.56 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,548.82 | Professional | None | $851.14 | $1,096.48 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,623.41 | Facility | None | $602.56 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,548.82 | Professional | None | $851.14 | $1,096.48 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $562.34 Typical High $977.24 | Professional | None | $70.79 | $562.34 | $977.24 |
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 $741.31 Median $812.83 Typical High $1,071.52 | Professional | None | $741.31 | $812.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $537.03 Median $912.01 Typical High $1,548.82 | Professional | None | $537.03 | $912.01 | $1,548.82 |
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 $416.87 Median $416.87 Typical High $1,412.54 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $562.34 | Professional | 53 · Discontinued | $165.96 | $165.96 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $426.58 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $281.84 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,174.90 Typical High $1,949.84 | Professional | 50 · Both sides | $933.25 | $1,174.90 | $1,949.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $109.65 Typical High $181.97 | Professional | AS · PA/NP assist | $87.10 | $109.65 | $181.97 |
Where Ohio sits
The same service costs 8.1 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
$708
AK $3,548TX $437
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.