How much rates vary
Facilitymedian $3,631 · 10th to 90th $692 to $10,471Professionalmedian $589 · 10th to 90th $87 to $977
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 $724.44 Median $724.44 Typical High $5,754.40 | Professional | None | $724.44 | $724.44 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $3,467.37 Typical High $12,022.64 | Facility | None | $676.08 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,148.15 | Professional | None | $524.81 | $660.69 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $4,365.16 | Facility | None | $912.01 | $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 $741.31 Median $933.25 Typical High $1,348.96 | Professional | None | $741.31 | $933.25 | $1,348.96 |
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 $741.31 Median $933.25 Typical High $1,318.26 | Professional | None | $741.31 | $933.25 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $478.63 Typical High $831.76 | Professional | None | $70.79 | $478.63 | $831.76 |
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 $630.96 Median $707.95 Typical High $912.01 | Professional | None | $630.96 | $707.95 | $912.01 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,318.26 | Professional | None | $457.09 | $758.58 | $1,318.26 |
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 $363.08 Median $363.08 Typical High $1,230.27 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $489.78 | Professional | 53 · Discontinued | $144.54 | $144.54 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $1,819.70 | Professional | 54 · Surgery only | $537.03 | $537.03 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $363.08 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $245.47 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,000.00 Typical High $1,698.24 | Professional | 50 · Both sides | $794.33 | $1,000.00 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $416.87 Typical High $707.95 | Professional | 62 · Two surgeons | $331.13 | $416.87 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $117.49 Typical High $524.81 | Professional | 80 · Assistant surgeon | $85.11 | $117.49 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $93.33 Typical High $158.49 | Professional | AS · PA/NP assist | $74.13 | $93.33 | $158.49 |
Where Ohio sits
The same service costs 7.9 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· 47th of 51
$617
AK $3,020TX $380
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.