How much rates vary
Facilitymedian $5,370 · 10th to 90th $912 to $13,804Professionalmedian $832 · 10th to 90th $89 to $1,380
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 $3,235.94 Median $10,232.93 Typical High $13,803.84 | Facility | None | $3,235.94 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $9,120.11 | Professional | None | $1,023.29 | $1,023.29 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $3,981.07 Typical High $19,054.61 | Facility | None | $954.99 | $3,981.07 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,621.81 | Professional | None | $776.25 | $977.24 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $169.82 Typical High $776.25 | Professional | 80 · Assistant surgeon | $125.89 | $169.82 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $9,332.54 Typical High $12,302.69 | Facility | None | $1,318.26 | $9,332.54 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $9,120.11 Typical High $14,454.40 | Facility | None | $794.33 | $9,120.11 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,348.96 | $1,949.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $9,120.11 Typical High $14,454.40 | Facility | None | $851.14 | $9,120.11 | $14,454.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,348.96 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $676.08 Typical High $1,174.90 | Professional | None | $70.79 | $676.08 | $1,174.90 |
SummaCare Setting Facility Modifier None Typical Low $5,011.87 Median $5,248.07 Typical High $5,888.44 | Facility | None | $5,011.87 | $5,248.07 | $5,888.44 |
SummaCare Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,288.25 | Professional | None | $891.25 | $1,000.00 | $1,288.25 |
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 $660.69 Median $1,096.48 Typical High $1,905.46 | Professional | None | $660.69 | $1,096.48 | $1,905.46 |
8 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 $512.86 Median $512.86 Typical High $1,737.80 | Professional | 52 · Reduced service | $512.86 | $512.86 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $691.83 | Professional | 53 · Discontinued | $204.17 | $204.17 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $2,630.27 | Professional | 54 · Surgery only | $776.25 | $776.25 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $524.81 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $346.74 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,479.11 Typical High $2,398.83 | Professional | 50 · Both sides | $1,174.90 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $138.04 Typical High $229.09 | Professional | AS · PA/NP assist | $109.65 | $138.04 | $229.09 |
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
$871
AK $4,365TX $550
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.