How much rates vary
Facilitymedian $2,291 · 10th to 90th $661 to $8,511Professionalmedian $550 · 10th to 90th $87 to $912
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 $2,290.87 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,290.87 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $5,754.40 | Professional | None | $676.08 | $676.08 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,698.24 Typical High $7,585.78 | Facility | None | $616.60 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,047.13 | Professional | None | $467.74 | $588.84 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $104.71 Typical High $467.74 | Professional | 80 · Assistant surgeon | $74.13 | $104.71 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,995.26 Typical High $2,570.40 | Facility | None | $870.96 | $1,995.26 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $3,467.37 | Facility | None | $602.56 | $2,238.72 | $3,467.37 |
Cigna 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 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $3,235.94 | Facility | None | $602.56 | $2,238.72 | $3,235.94 |
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 $446.68 Typical High $794.33 | Professional | None | $70.79 | $446.68 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,318.26 | Facility | None | $1,096.48 | $1,148.15 | $1,318.26 |
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 $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,258.93 | Professional | None | $436.52 | $691.83 | $1,258.93 |
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 $1,148.15 | Professional | 52 · Reduced service | $338.84 | $338.84 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $457.09 | Professional | 53 · Discontinued | $134.90 | $134.90 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $1,737.80 | Professional | 54 · Surgery only | $512.86 | $512.86 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $346.74 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $229.09 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $870.96 Typical High $1,548.82 | Professional | 50 · Both sides | $707.95 | $870.96 | $1,548.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $81.28 Typical High $147.91 | Professional | AS · PA/NP assist | $66.07 | $81.28 | $147.91 |
Where Ohio sits
The same service costs 8.5 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· 47th of 51
$575
AK $2,884TX $339
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.