How much rates vary
Facilitymedian $4,467 · 10th to 90th $724 to $12,023Professionalmedian $776 · 10th to 90th $89 to $1,288
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 $891.25 Median $891.25 Typical High $5,754.40 | Professional | None | $891.25 | $891.25 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $3,890.45 Typical High $19,054.61 | Facility | None | $831.76 | $3,890.45 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,659.59 | Professional | None | $831.76 | $1,047.13 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $169.82 Typical High $831.76 | Professional | 80 · Assistant surgeon | $131.83 | $169.82 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $6,456.54 Typical High $8,317.64 | Facility | None | $1,148.15 | $6,456.54 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,456.54 Typical High $10,232.93 | Facility | None | $602.56 | $6,456.54 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,698.24 | Professional | None | $912.01 | $1,148.15 | $1,698.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $6,456.54 Typical High $10,232.93 | Facility | None | $602.56 | $6,456.54 | $10,232.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,737.80 | Professional | None | $912.01 | $1,148.15 | $1,737.80 |
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 $3,548.13 Median $3,715.35 Typical High $4,168.69 | Facility | None | $3,548.13 | $3,715.35 | $4,168.69 |
SummaCare Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,122.02 | Professional | None | $776.25 | $870.96 | $1,122.02 |
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 $575.44 Median $977.24 Typical High $1,698.24 | Professional | None | $575.44 | $977.24 | $1,698.24 |
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 $446.68 Median $446.68 Typical High $1,513.56 | Professional | 52 · Reduced service | $446.68 | $446.68 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $602.56 | Professional | 53 · Discontinued | $177.83 | $177.83 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $2,238.72 | Professional | 54 · Surgery only | $676.08 | $676.08 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $446.68 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $302.00 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,548.82 Typical High $2,454.71 | Professional | 50 · Both sides | $1,258.93 | $1,548.82 | $2,454.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $144.54 Typical High $229.09 | Professional | AS · PA/NP assist | $117.49 | $144.54 | $229.09 |
Where Ohio sits
The same service costs 7.9 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
$794
AK $3,715TX $468
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.