How much rates vary
Facilitymedian $3,467 · 10th to 90th $661 to $11,220Professionalmedian $851 · 10th to 90th $135 to $1,413
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 $1,096.48 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,096.48 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $3,981.07 | Professional | None | $1,096.48 | $1,096.48 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,698.24 | Professional | None | $794.33 | $1,000.00 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $6,606.93 Typical High $10,964.78 | Facility | None | $588.84 | $6,606.93 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,412.54 | $2,089.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $6,606.93 Typical High $10,232.93 | Facility | None | $588.84 | $6,606.93 | $10,232.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,412.54 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $691.83 Typical High $1,230.27 | Professional | None | $107.15 | $691.83 | $1,230.27 |
SummaCare Setting Facility Modifier None Typical Low $3,548.13 Median $3,715.35 Typical High $4,168.69 | Facility | None | $3,548.13 | $3,715.35 | $4,168.69 |
SummaCare Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,380.38 | Professional | None | $954.99 | $1,047.13 | $1,380.38 |
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 $707.95 Median $1,174.90 Typical High $2,041.74 | Professional | None | $707.95 | $1,174.90 | $2,041.74 |
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 $549.54 Median $549.54 Typical High $1,862.09 | Professional | 52 · Reduced service | $549.54 | $549.54 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $741.31 | Professional | 53 · Discontinued | $218.78 | $218.78 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $2,754.23 | Professional | 54 · Surgery only | $812.83 | $812.83 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $549.54 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $371.54 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,513.56 Typical High $2,511.89 | Professional | 50 · Both sides | $1,202.26 | $1,513.56 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $630.96 Typical High $1,047.13 | Professional | 62 · Two surgeons | $501.19 | $630.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $173.78 Typical High $794.33 | Professional | 80 · Assistant surgeon | $128.82 | $173.78 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $141.25 Typical High $239.88 | Professional | AS · PA/NP assist | $112.20 | $141.25 | $239.88 |
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
$891
AK $4,571TX $550
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.