How much rates vary
Facilitymedian $3,467 · 10th to 90th $661 to $12,882Professionalmedian $708 · 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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $4,168.69 | Professional | None | $912.01 | $912.01 | $4,168.69 |
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 $602.56 Median $758.58 Typical High $1,318.26 | Professional | None | $602.56 | $758.58 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $9,332.54 Typical High $15,135.61 | Facility | None | $588.84 | $9,332.54 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,584.89 | Professional | None | $912.01 | $1,174.90 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $9,332.54 Typical High $14,454.40 | Facility | None | $588.84 | $9,332.54 | $14,454.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,584.89 | Professional | None | $912.01 | $1,174.90 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $588.84 Typical High $1,023.29 | Professional | None | $70.79 | $588.84 | $1,023.29 |
SummaCare Setting Facility Modifier None Typical Low $9,772.37 Median $10,232.93 Typical High $11,748.98 | Facility | None | $9,772.37 | $10,232.93 | $11,748.98 |
SummaCare Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,148.15 | Professional | None | $794.33 | $870.96 | $1,148.15 |
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 $588.84 Median $891.25 Typical High $1,659.59 | Professional | None | $588.84 | $891.25 | $1,659.59 |
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 $457.09 Median $457.09 Typical High $1,905.46 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $776.25 | Professional | 53 · Discontinued | $181.97 | $181.97 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $2,884.03 | Professional | 54 · Surgery only | $676.08 | $676.08 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $575.44 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $389.05 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,148.15 Typical High $1,949.84 | Professional | 50 · Both sides | $912.01 | $1,148.15 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $123.03 Typical High $208.93 | Professional | 80 · Assistant surgeon | $97.72 | $123.03 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $107.15 Typical High $186.21 | Professional | AS · PA/NP assist | $85.11 | $107.15 | $186.21 |
Where Ohio sits
The same service costs 16.2 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
$741
AK $3,802TX $234
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.