How much rates vary
Facilitymedian $3,090 · 10th to 90th $661 to $10,471Professionalmedian $589 · 10th to 90th $87 to $955
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 $891.25 Median $10,232.93 Typical High $13,803.84 | Facility | None | $891.25 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,344.23 | Professional | None | $691.83 | $691.83 | $2,344.23 |
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 $630.96 Median $794.33 Typical High $1,258.93 | Professional | None | $630.96 | $794.33 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $125.89 Typical High $630.96 | Professional | 80 · Assistant surgeon | $100.00 | $125.89 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,630.78 Typical High $5,888.44 | Facility | None | $588.84 | $3,630.78 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,288.25 | Professional | None | $691.83 | $891.25 | $1,288.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $3,630.78 Typical High $5,623.41 | Facility | None | $588.84 | $3,630.78 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,348.96 | Professional | None | $691.83 | $891.25 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $446.68 Typical High $758.58 | Professional | None | $70.79 | $446.68 | $758.58 |
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 $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
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 $436.52 Median $758.58 Typical High $1,288.25 | Professional | None | $436.52 | $758.58 | $1,288.25 |
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 $338.84 Median $338.84 Typical High $1,047.13 | Professional | 52 · Reduced service | $338.84 | $338.84 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $426.58 | Professional | 53 · Discontinued | $138.04 | $138.04 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $1,584.89 | Professional | 54 · Surgery only | $512.86 | $512.86 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $316.23 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $208.93 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,174.90 Typical High $1,862.09 | Professional | 50 · Both sides | $933.25 | $1,174.90 | $1,862.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $109.65 Typical High $177.83 | Professional | AS · PA/NP assist | $87.10 | $109.65 | $177.83 |
Where Ohio sits
The same service costs 8.7 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
$603
AK $2,884TX $331
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.