How much rates vary
Facilitymedian $1,905 · 10th to 90th $646 to $10,233Professionalmedian $562 · 10th to 90th $87 to $933
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 $2,238.72 | Professional | None | $691.83 | $691.83 | $2,238.72 |
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 $501.19 Median $630.96 Typical High $1,071.52 | Professional | None | $501.19 | $630.96 | $1,071.52 |
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 $549.54 Median $1,737.80 Typical High $2,691.53 | Facility | None | $549.54 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,258.93 | Professional | None | $691.83 | $870.96 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,691.53 | Facility | None | $549.54 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,230.27 | Professional | None | $691.83 | $870.96 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $467.74 Typical High $831.76 | Professional | None | $70.79 | $467.74 | $831.76 |
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 $616.60 Median $691.83 Typical High $891.25 | Professional | None | $616.60 | $691.83 | $891.25 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $10,471.29 | Facility | None | $912.01 | $3,388.44 | $10,471.29 |
United Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $1,258.93 | Professional | None | $436.52 | $724.44 | $1,258.93 |
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 $346.74 Median $346.74 Typical High $1,023.29 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $407.38 | Professional | 53 · Discontinued | $138.04 | $138.04 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $1,513.56 | Professional | 54 · Surgery only | $512.86 | $512.86 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $309.03 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $204.17 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $933.25 Typical High $1,621.81 | Professional | 50 · Both sides | $758.58 | $933.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $100.00 Typical High $173.78 | Professional | 80 · Assistant surgeon | $79.43 | $100.00 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $87.10 Typical High $151.36 | Professional | AS · PA/NP assist | $70.79 | $87.10 | $151.36 |
Where Ohio sits
The same service costs 19.5 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· 48th of 51
$589
AK $2,951TX $151
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.