How much rates vary
Facilitymedian $3,890 · 10th to 90th $708 to $11,220Professionalmedian $1,148 · 10th to 90th $135 to $1,905
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $6,309.57 | Professional | None | $1,412.54 | $1,412.54 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $7,585.78 | Facility | None | $645.65 | $1,737.80 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,380.38 | $2,187.76 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $7,585.78 | Facility | None | $588.84 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,862.09 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $7,079.46 | Facility | None | $588.84 | $4,570.88 | $7,079.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,862.09 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $912.01 Typical High $1,621.81 | Professional | None | $107.15 | $912.01 | $1,621.81 |
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 $1,230.27 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,348.96 | $1,778.28 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $2,691.53 | Professional | None | $912.01 | $1,548.82 | $2,691.53 |
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 $707.95 Median $707.95 Typical High $2,754.23 | Professional | 52 · Reduced service | $707.95 | $707.95 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $1,096.48 | Professional | 53 · Discontinued | $281.84 | $281.84 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $4,073.80 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $831.76 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $549.54 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,089.30 Typical High $3,311.31 | Professional | 50 · Both sides | $1,659.59 | $2,089.30 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $870.96 Typical High $1,412.54 | Professional | 62 · Two surgeons | $691.83 | $870.96 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $223.87 Typical High $363.08 | Professional | 80 · Assistant surgeon | $177.83 | $223.87 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $194.98 Typical High $316.23 | Professional | AS · PA/NP assist | $154.88 | $194.98 | $316.23 |
Where Ohio sits
The same service costs 8.7 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
$1,175
AK $5,888TX $676
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.