How much rates vary
Facilitymedian $2,344 · 10th to 90th $661 to $9,120Professionalmedian $1,202 · 10th to 90th $135 to $1,950
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $6,606.93 | Professional | None | $1,479.11 | $1,479.11 | $6,606.93 |
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 $1,148.15 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,445.44 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,238.72 Typical High $3,467.37 | Facility | None | $588.84 | $2,238.72 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,949.84 | $2,884.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $2,238.72 Typical High $3,311.31 | Facility | None | $588.84 | $2,238.72 | $3,311.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,513.56 | $1,949.84 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $954.99 Typical High $1,659.59 | Professional | None | $107.15 | $954.99 | $1,659.59 |
SummaCare Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,288.25 | Facility | None | $1,071.52 | $1,122.02 | $1,288.25 |
SummaCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,412.54 | $1,862.09 |
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 $977.24 Median $1,621.81 Typical High $2,818.38 | Professional | None | $977.24 | $1,621.81 | $2,818.38 |
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 $741.31 Median $741.31 Typical High $2,884.03 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $1,148.15 | Professional | 53 · Discontinued | $302.00 | $302.00 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $870.96 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $575.44 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,137.96 Typical High $3,467.37 | Professional | 50 · Both sides | $1,698.24 | $2,137.96 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $229.09 Typical High $371.54 | Professional | 80 · Assistant surgeon | $181.97 | $229.09 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $199.53 Typical High $331.13 | Professional | AS · PA/NP assist | $158.49 | $199.53 | $331.13 |
Where Ohio sits
The same service costs 16.2 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
$1,202
AK $6,310TX $389
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.