How much rates vary
Facilitymedian $4,786 · 10th to 90th $871 to $12,023Professionalmedian $724 · 10th to 90th $89 to $1,175
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 $3,162.28 Median $10,232.93 Typical High $13,803.84 | Facility | None | $3,162.28 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $9,120.11 | Professional | None | $870.96 | $870.96 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $12,022.64 | Facility | None | $954.99 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,380.38 | Professional | None | $691.83 | $851.14 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $4,897.79 Typical High $6,309.57 | Facility | None | $1,122.02 | $4,897.79 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,897.79 Typical High $7,943.28 | Facility | None | $794.33 | $4,897.79 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,621.81 | Professional | None | $891.25 | $1,148.15 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $4,897.79 Typical High $7,762.47 | Facility | None | $851.14 | $4,897.79 | $7,762.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,621.81 | Professional | None | $891.25 | $1,148.15 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $588.84 Typical High $1,000.00 | Professional | None | $70.79 | $588.84 | $1,000.00 |
SummaCare Setting Facility Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $3,162.28 | Facility | None | $2,691.53 | $2,818.38 | $3,162.28 |
SummaCare Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,096.48 | Professional | None | $776.25 | $851.14 | $1,096.48 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $10,232.93 | Facility | None | $851.14 | $2,630.27 | $10,232.93 |
United Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $1,621.81 | Professional | None | $562.34 | $954.99 | $1,621.81 |
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 $436.52 Median $436.52 Typical High $1,479.11 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $588.84 | Professional | 53 · Discontinued | $173.78 | $173.78 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $2,238.72 | Professional | 54 · Surgery only | $660.69 | $660.69 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $446.68 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $295.12 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,288.25 Typical High $2,041.74 | Professional | 50 · Both sides | $1,023.29 | $1,288.25 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $537.03 Typical High $870.96 | Professional | 62 · Two surgeons | $426.58 | $537.03 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $138.04 Typical High $223.87 | Professional | 80 · Assistant surgeon | $109.65 | $138.04 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $120.23 Typical High $199.53 | Professional | AS · PA/NP assist | $95.50 | $120.23 | $199.53 |
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· 48th of 51
$741
AK $3,715TX $468
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.