How much rates vary
Facilitymedian $3,388 · 10th to 90th $708 to $10,233Professionalmedian $589 · 10th to 90th $89 to $955
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 $707.95 Median $707.95 Typical High $5,754.40 | Professional | None | $707.95 | $707.95 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $7,762.47 | Facility | None | $645.65 | $1,862.09 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,096.48 | Professional | None | $537.03 | $660.69 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $3,388.44 Typical High $4,365.16 | Facility | None | $891.25 | $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 $724.44 Median $912.01 Typical High $1,318.26 | Professional | None | $724.44 | $912.01 | $1,318.26 |
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 $724.44 Median $912.01 Typical High $1,288.25 | Professional | None | $724.44 | $912.01 | $1,288.25 |
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 $616.60 Median $691.83 Typical High $891.25 | Professional | None | $616.60 | $691.83 | $891.25 |
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 $446.68 Median $758.58 Typical High $1,288.25 | Professional | None | $446.68 | $758.58 | $1,288.25 |
9 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 $346.74 Median $346.74 Typical High $1,174.90 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $478.63 | Professional | 53 · Discontinued | $141.25 | $141.25 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,778.28 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $354.81 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $239.88 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,000.00 Typical High $1,621.81 | Professional | 50 · Both sides | $794.33 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $107.15 Typical High $177.83 | Professional | 80 · Assistant surgeon | $85.11 | $107.15 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $100.00 Typical High $165.96 | Professional | AS · PA/NP assist | $74.13 | $100.00 | $165.96 |
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· 47th of 51
$617
AK $2,951TX $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.