How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $10,233Professionalmedian $513 · 10th to 90th $79 to $851
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 $2,187.76 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,187.76 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $6,606.93 | Professional | None | $616.60 | $616.60 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $12,022.64 | Facility | None | $794.33 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $977.24 | Professional | None | $457.09 | $575.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $851.14 Typical High $1,445.44 | Professional | 50 · Both sides | $691.83 | $851.14 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $100.00 Typical High $457.09 | Professional | 80 · Assistant surgeon | $72.44 | $100.00 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $3,388.44 Typical High $4,365.16 | Facility | None | $776.25 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,888.44 | Facility | None | $741.31 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,122.02 | Professional | None | $630.96 | $794.33 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,623.41 | Facility | None | $741.31 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,122.02 | Professional | None | $630.96 | $794.33 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $346.74 Typical High $724.44 | Professional | None | $67.61 | $346.74 | $724.44 |
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 $549.54 Median $602.56 Typical High $794.33 | Professional | None | $549.54 | $602.56 | $794.33 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $1,122.02 | Professional | None | $389.05 | $660.69 | $1,122.02 |
7 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 $309.03 Median $309.03 Typical High $1,047.13 | Professional | 52 · Reduced service | $309.03 | $309.03 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $416.87 | Professional | 53 · Discontinued | $123.03 | $123.03 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $1,548.82 | Professional | 54 · Surgery only | $457.09 | $457.09 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $309.03 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $208.93 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $79.43 Typical High $134.90 | Professional | AS · PA/NP assist | $64.57 | $79.43 | $134.90 |
Where Ohio sits
The same service costs 8.3 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
$550
AK $2,570TX $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.