How much rates vary
Facilitymedian $3,162 · 10th to 90th $661 to $9,550Professionalmedian $708 · 10th to 90th $87 to $1,175
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 $851.14 Median $851.14 Typical High $5,754.40 | Professional | None | $851.14 | $851.14 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | None | $645.65 | $812.83 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,071.52 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $7,079.46 | Facility | None | $602.56 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,548.82 | Professional | None | $851.14 | $1,047.13 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $6,918.31 | Facility | None | $602.56 | $4,466.84 | $6,918.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,548.82 | Professional | None | $851.14 | $1,047.13 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $575.44 Typical High $1,023.29 | Professional | None | $70.79 | $575.44 | $1,023.29 |
SummaCare Setting Facility Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,398.83 | $2,511.89 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,122.02 | Professional | None | $776.25 | $851.14 | $1,122.02 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,548.82 | Professional | None | $524.81 | $891.25 | $1,548.82 |
10 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 $416.87 Median $416.87 Typical High $1,513.56 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $602.56 | Professional | 53 · Discontinued | $169.82 | $169.82 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,290.87 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $457.09 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $302.00 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,202.26 Typical High $1,995.26 | Professional | 50 · Both sides | $977.24 | $1,202.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $512.86 Typical High $851.14 | Professional | 62 · Two surgeons | $407.38 | $512.86 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $134.90 Typical High $645.65 | Professional | 80 · Assistant surgeon | $104.71 | $134.90 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $112.20 Typical High $190.55 | Professional | AS · PA/NP assist | $91.20 | $112.20 | $190.55 |
Where Ohio sits
The same service costs 8.1 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
$741
AK $3,631TX $447
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.