How much rates vary
Facilitymedian $2,188 · 10th to 90th $692 to $9,550Professionalmedian $851 · 10th to 90th $89 to $1,349
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 $977.24 Median $977.24 Typical High $5,754.40 | Professional | None | $977.24 | $977.24 | $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 $891.25 Median $1,096.48 Typical High $1,737.80 | Professional | None | $891.25 | $1,096.48 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $177.83 Typical High $891.25 | Professional | 80 · Assistant surgeon | $141.25 | $177.83 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,258.93 | $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 $1,000.00 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,288.25 | $1,862.09 |
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 $1,000.00 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,288.25 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $630.96 Typical High $1,096.48 | Professional | None | $70.79 | $630.96 | $1,096.48 |
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 $870.96 Median $954.99 Typical High $1,230.27 | Professional | None | $870.96 | $954.99 | $1,230.27 |
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 $630.96 Median $1,096.48 Typical High $1,862.09 | Professional | None | $630.96 | $1,096.48 | $1,862.09 |
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 $489.78 Median $489.78 Typical High $1,862.09 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $758.58 | Professional | 53 · Discontinued | $194.98 | $194.98 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $2,818.38 | Professional | 54 · Surgery only | $741.31 | $741.31 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $562.34 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $380.19 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,659.59 Typical High $2,570.40 | Professional | 50 · Both sides | $1,318.26 | $1,659.59 | $2,570.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $154.88 Typical High $239.88 | Professional | AS · PA/NP assist | $123.03 | $154.88 | $239.88 |
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
$871
AK $4,169TX $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.