How much rates vary
Facilitymedian $2,188 · 10th to 90th $692 to $9,550Professionalmedian $646 · 10th to 90th $87 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 $741.31 Median $741.31 Typical High $5,754.40 | Professional | None | $741.31 | $741.31 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $7,585.78 | Facility | None | $645.65 | $1,778.28 | $7,585.78 |
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 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $147.91 Typical High $741.31 | Professional | 80 · Assistant surgeon | $120.23 | $147.91 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $1,995.26 | Facility | None | $954.99 | $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 $758.58 Median $954.99 Typical High $1,445.44 | Professional | None | $758.58 | $954.99 | $1,445.44 |
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 $758.58 Median $954.99 Typical High $1,445.44 | Professional | None | $758.58 | $954.99 | $1,445.44 |
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 $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 $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
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 |
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 $371.54 Median $371.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $562.34 | Professional | 53 · Discontinued | $147.91 | $147.91 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $2,137.96 | Professional | 54 · Surgery only | $562.34 | $562.34 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $426.58 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $281.84 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,380.38 Typical High $2,089.30 | Professional | 50 · Both sides | $1,122.02 | $1,380.38 | $2,089.30 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $128.82 Typical High $194.98 | Professional | AS · PA/NP assist | $104.71 | $128.82 | $194.98 |
Where Ohio sits
The same service costs 8.3 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 $380
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.