How much rates vary
Facilitymedian $3,467 · 10th to 90th $646 to $10,471Professionalmedian $2,884 · 10th to 90th $468 to $4,898
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 $3,715.35 Median $8,709.64 Typical High $13,803.84 | Facility | None | $3,715.35 | $8,709.64 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $10,715.19 | Professional | None | $3,715.35 | $3,715.35 | $10,715.19 |
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 $2,818.38 Median $3,467.37 Typical High $6,025.60 | Professional | None | $2,818.38 | $3,467.37 | $6,025.60 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $831.76 Typical High $4,677.35 | Facility | None | $562.34 | $831.76 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $4,466.84 Typical High $7,079.46 | Facility | None | $537.03 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $4,786.30 Typical High $6,606.93 | Professional | None | $3,630.78 | $4,786.30 | $6,606.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $549.54 | $4,466.84 | $7,079.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3,715.35 Median $4,786.30 Typical High $6,309.57 | Professional | None | $3,715.35 | $4,786.30 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $2,290.87 Typical High $4,073.80 | Professional | None | $389.05 | $2,290.87 | $4,073.80 |
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 $3,162.28 Median $3,467.37 Typical High $4,570.88 | Professional | None | $3,162.28 | $3,467.37 | $4,570.88 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $3,981.07 Typical High $6,918.31 | Professional | None | $2,398.83 | $3,981.07 | $6,918.31 |
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 $1,819.70 Median $1,819.70 Typical High $5,011.87 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $741.31 Typical High $2,041.74 | Professional | 53 · Discontinued | $741.31 | $741.31 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,754.23 Typical High $7,585.78 | Professional | 54 · Surgery only | $2,754.23 | $2,754.23 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $549.54 Typical High $1,513.56 | Professional | 55 · Aftercare only | $549.54 | $549.54 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,570.40 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,570.40 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,168.69 Median $5,248.07 Typical High $8,912.51 | Professional | 50 · Both sides | $4,168.69 | $5,248.07 | $8,912.51 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,778.28 Median $2,187.76 Typical High $3,801.89 | Professional | 62 · Two surgeons | $1,778.28 | $2,187.76 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $562.34 Typical High $954.99 | Professional | 80 · Assistant surgeon | $446.68 | $562.34 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $489.78 Typical High $831.76 | Professional | AS · PA/NP assist | $389.05 | $489.78 | $831.76 |
Where Ohio sits
The same service costs 20.4 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
$2,884
AK $15,488TX $759
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.