How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $9,120Professionalmedian $479 · 10th to 90th $87 to $794
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 $2,089.30 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,089.30 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $5,754.40 | Professional | None | $602.56 | $602.56 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $912.01 | Professional | None | $426.58 | $537.03 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,513.56 Typical High $1,995.26 | Facility | None | $776.25 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,122.02 | Professional | None | $630.96 | $776.25 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,122.02 | Professional | None | $630.96 | $776.25 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $389.05 Typical High $691.83 | Professional | None | $70.79 | $389.05 | $691.83 |
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 $537.03 Median $602.56 Typical High $776.25 | Professional | None | $537.03 | $602.56 | $776.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $1,122.02 | Professional | None | $389.05 | $645.65 | $1,122.02 |
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 $302.00 Median $302.00 Typical High $1,023.29 | Professional | 52 · Reduced service | $302.00 | $302.00 | $1,023.29 |
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 $60.26 Median $60.26 Typical High $204.17 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $204.17 |
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 50 · Both sides Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | 50 · Both sides | $645.65 | $812.83 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $338.84 Typical High $575.44 | Professional | 62 · Two surgeons | $269.15 | $338.84 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $93.33 Typical High $426.58 | Professional | 80 · Assistant surgeon | $69.18 | $93.33 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $75.86 Typical High $128.82 | Professional | AS · PA/NP assist | $60.26 | $75.86 | $128.82 |
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
$501
AK $2,570TX $331
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.