How much rates vary
Facilitymedian $3,631 · 10th to 90th $692 to $10,471Professionalmedian $646 · 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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $5,754.40 | Professional | None | $758.58 | $758.58 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $3,467.37 Typical High $12,022.64 | Facility | None | $676.08 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,412.54 | Professional | None | $741.31 | $933.25 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $3,388.44 Typical High $4,365.16 | Facility | None | $954.99 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,888.44 | Facility | None | $602.56 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,445.44 | Professional | None | $758.58 | $977.24 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,623.41 | Facility | None | $602.56 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,479.11 | Professional | None | $758.58 | $977.24 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $501.19 Typical High $851.14 | Professional | None | $70.79 | $501.19 | $851.14 |
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 $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $1,445.44 | Professional | None | $478.63 | $831.76 | $1,445.44 |
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 $371.54 Median $371.54 Typical High $1,445.44 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $575.44 | Professional | 53 · Discontinued | $151.36 | $151.36 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $2,187.76 | Professional | 54 · Surgery only | $562.34 | $562.34 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $436.52 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $288.40 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $2,089.30 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $147.91 Typical High $223.87 | Professional | 80 · Assistant surgeon | $117.49 | $147.91 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $194.98 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $194.98 |
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· 47th of 51
$676
AK $3,162TX $417
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.