How much rates vary
Facilitymedian $1,862 · 10th to 90th $646 to $8,511Professionalmedian $457 · 10th to 90th $79 to $759
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 $1,995.26 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,995.26 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $5,754.40 | Professional | None | $562.34 | $562.34 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $870.96 | Professional | None | $407.38 | $512.86 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $89.13 Typical High $407.38 | Professional | 80 · Assistant surgeon | $66.07 | $89.13 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,513.56 Typical High $1,995.26 | Facility | None | $707.95 | $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 $575.44 Median $707.95 Typical High $1,023.29 | Professional | None | $575.44 | $707.95 | $1,023.29 |
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 $575.44 Median $707.95 Typical High $1,023.29 | Professional | None | $575.44 | $707.95 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $371.54 Typical High $660.69 | Professional | None | $70.79 | $371.54 | $660.69 |
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 $501.19 Median $549.54 Typical High $724.44 | Professional | None | $501.19 | $549.54 | $724.44 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $1,023.29 | Professional | None | $354.81 | $588.84 | $1,023.29 |
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 $275.42 Median $275.42 Typical High $933.25 | Professional | 52 · Reduced service | $275.42 | $275.42 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $380.19 | Professional | 53 · Discontinued | $112.20 | $112.20 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $1,412.54 | Professional | 54 · Surgery only | $416.87 | $416.87 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $281.84 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $190.55 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $758.58 Typical High $1,288.25 | Professional | 50 · Both sides | $616.60 | $758.58 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $70.79 Typical High $120.23 | Professional | AS · PA/NP assist | $57.54 | $70.79 | $120.23 |
Where Ohio sits
The same service costs 8.9 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· 47th of 51
$479
AK $2,344TX $263
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.