How much rates vary
Facilitymedian $1,905 · 10th to 90th $603 to $8,318Professionalmedian $1,288 · 10th to 90th $178 to $2,138
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 $1,949.84 Median $4,570.88 Typical High $12,589.25 | Facility | None | $1,949.84 | $4,570.88 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $7,244.36 | Professional | None | $1,584.89 | $1,584.89 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $7,585.78 | Facility | None | $588.84 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,445.44 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,513.56 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $2,511.89 | Facility | None | $489.78 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,089.30 | $2,884.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $2,454.71 | Facility | None | $512.86 | $1,737.80 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,659.59 | $2,089.30 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $1,047.13 Typical High $1,819.70 | Professional | None | $141.25 | $1,047.13 | $1,819.70 |
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 $1,412.54 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,548.82 | $2,041.74 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,023.29 | $1,698.24 | $2,951.21 |
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 $794.33 Median $794.33 Typical High $3,388.44 | Professional | 52 · Reduced service | $794.33 | $794.33 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $1,348.96 | Professional | 53 · Discontinued | $316.23 | $316.23 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $5,011.87 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $1,000.00 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $676.08 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,187.76 Typical High $3,801.89 | Professional | 50 · Both sides | $1,737.80 | $2,187.76 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $229.09 Typical High $407.38 | Professional | 80 · Assistant surgeon | $186.21 | $229.09 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $363.08 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $363.08 |
Where Ohio sits
The same service costs 7.8 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
$1,318
AK $6,761TX $871
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.