How much rates vary
Facilitymedian $1,738 · 10th to 90th $468 to $7,586Professionalmedian $339 · 10th to 90th $43 to $550
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 $1,380.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $2,630.27 | Professional | None | $407.38 | $407.38 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,584.89 Typical High $7,585.78 | Facility | None | $549.54 | $1,584.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $630.96 | Professional | None | $288.40 | $363.08 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $1,513.56 Typical High $1,995.26 | Facility | None | $524.81 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,621.81 Typical High $2,511.89 | Facility | None | $363.08 | $1,621.81 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $758.58 | Professional | None | $416.87 | $524.81 | $758.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,621.81 Typical High $2,454.71 | Facility | None | $389.05 | $1,621.81 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $758.58 | Professional | None | $416.87 | $524.81 | $758.58 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $269.15 Typical High $478.63 | Professional | None | $33.88 | $269.15 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $537.03 | Professional | None | $371.54 | $416.87 | $537.03 |
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 $263.03 Median $436.52 Typical High $758.58 | Professional | None | $263.03 | $436.52 | $758.58 |
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 $204.17 Median $204.17 Typical High $707.95 | Professional | 52 · Reduced service | $204.17 | $204.17 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $281.84 | Professional | 53 · Discontinued | $83.18 | $83.18 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $1,047.13 | Professional | 54 · Surgery only | $309.03 | $309.03 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $208.93 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $141.25 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $549.54 Typical High $933.25 | Professional | 50 · Both sides | $436.52 | $549.54 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $181.97 Median $229.09 Typical High $398.11 | Professional | 62 · Two surgeons | $181.97 | $229.09 | $398.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $64.57 Typical High $288.40 | Professional | 80 · Assistant surgeon | $46.77 | $64.57 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $51.29 Typical High $89.13 | Professional | AS · PA/NP assist | $40.74 | $51.29 | $89.13 |
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
$355
AK $1,738TX $209
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.