How much rates vary
Facilitymedian $1,995 · 10th to 90th $741 to $9,120Professionalmedian $479 · 10th to 90th $89 to $794
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 $2,089.30 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,089.30 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $5,128.61 | Professional | None | $575.44 | $575.44 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $7,762.47 | Facility | None | $691.83 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $933.25 | Professional | None | $426.58 | $537.03 | $933.25 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,513.56 Typical High $1,995.26 | Facility | None | $741.31 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $3,019.95 | Facility | None | $741.31 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,071.52 | Professional | None | $588.84 | $741.31 | $1,071.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,951.21 | Facility | None | $741.31 | $1,737.80 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,071.52 | Professional | None | $588.84 | $741.31 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $389.05 Typical High $676.08 | Professional | None | $70.79 | $389.05 | $676.08 |
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 $512.86 Median $562.34 Typical High $741.31 | Professional | None | $512.86 | $562.34 | $741.31 |
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 $363.08 Median $616.60 Typical High $1,047.13 | Professional | None | $363.08 | $616.60 | $1,047.13 |
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 $288.40 Median $288.40 Typical High $977.24 | Professional | 52 · Reduced service | $288.40 | $288.40 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $389.05 | Professional | 53 · Discontinued | $114.82 | $114.82 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $1,445.44 | Professional | 54 · Surgery only | $436.52 | $436.52 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $295.12 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $194.98 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $794.33 Typical High $1,412.54 | Professional | 50 · Both sides | $645.65 | $794.33 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $338.84 Typical High $588.84 | Professional | 62 · Two surgeons | $269.15 | $338.84 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $95.50 Typical High $426.58 | Professional | 80 · Assistant surgeon | $67.61 | $95.50 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $74.13 Typical High $131.83 | Professional | AS · PA/NP assist | $60.26 | $74.13 | $131.83 |
Where Ohio sits
The same service costs 14.1 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
$501
AK $2,455TX $174
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.