How much rates vary
Facilitymedian $3,802 · 10th to 90th $813 to $10,965Professionalmedian $676 · 10th to 90th $89 to $1,072
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $6,606.93 | Professional | None | $812.83 | $812.83 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $3,467.37 Typical High $12,022.64 | Facility | None | $831.76 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,258.93 | Professional | None | $602.56 | $758.58 | $1,258.93 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,023.29 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,888.44 | Facility | None | $741.31 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,513.56 | Professional | None | $831.76 | $1,047.13 | $1,513.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,623.41 | Facility | None | $741.31 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,479.11 | Professional | None | $831.76 | $1,047.13 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $562.34 Typical High $933.25 | Professional | None | $70.79 | $562.34 | $933.25 |
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 $707.95 Median $794.33 Typical High $1,023.29 | Professional | None | $707.95 | $794.33 | $1,023.29 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $524.81 Median $870.96 Typical High $1,479.11 | Professional | None | $524.81 | $870.96 | $1,479.11 |
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 $407.38 Median $407.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $549.54 | Professional | 53 · Discontinued | $162.18 | $162.18 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $2,041.74 | Professional | 54 · Surgery only | $602.56 | $602.56 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $407.38 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $275.42 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,122.02 Typical High $1,862.09 | Professional | 50 · Both sides | $912.01 | $1,122.02 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $478.63 Typical High $794.33 | Professional | 62 · Two surgeons | $380.19 | $478.63 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $120.23 Typical High $199.53 | Professional | 80 · Assistant surgeon | $95.50 | $120.23 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $104.71 Typical High $177.83 | Professional | AS · PA/NP assist | $85.11 | $104.71 | $177.83 |
Where Ohio sits
The same service costs 7.6 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
$692
AK $3,388TX $447
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.