How much rates vary
Facilitymedian $4,266 · 10th to 90th $724 to $10,965Professionalmedian $468 · 10th to 90th $89 to $759
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 $2,041.74 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,041.74 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $4,168.69 | Professional | None | $562.34 | $562.34 | $4,168.69 |
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 $416.87 Median $512.86 Typical High $870.96 | Professional | None | $416.87 | $512.86 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $89.13 Typical High $416.87 | Professional | 80 · Assistant surgeon | $66.07 | $89.13 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $3,388.44 Typical High $4,365.16 | Facility | None | $724.44 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $7,079.46 | Facility | None | $602.56 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,023.29 | Professional | None | $575.44 | $724.44 | $1,023.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $6,918.31 | Facility | None | $602.56 | $4,466.84 | $6,918.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,023.29 | Professional | None | $575.44 | $724.44 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $371.54 Typical High $660.69 | Professional | None | $70.79 | $371.54 | $660.69 |
SummaCare Setting Facility Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,398.83 | $2,511.89 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $724.44 | Professional | None | $501.19 | $549.54 | $724.44 |
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 $354.81 Median $602.56 Typical High $1,023.29 | Professional | None | $354.81 | $602.56 | $1,023.29 |
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 $281.84 Median $281.84 Typical High $954.99 | Professional | 52 · Reduced service | $281.84 | $281.84 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $380.19 | Professional | 53 · Discontinued | $112.20 | $112.20 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $1,445.44 | Professional | 54 · Surgery only | $416.87 | $416.87 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $288.40 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $190.55 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $776.25 Typical High $1,318.26 | Professional | 50 · Both sides | $616.60 | $776.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $72.44 Typical High $123.03 | Professional | AS · PA/NP assist | $57.54 | $72.44 | $123.03 |
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· 48th of 51
$490
AK $2,399TX $309
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.