How much rates vary
Facilitymedian $3,981 · 10th to 90th $891 to $11,220Professionalmedian $692 · 10th to 90th $81 to $1,148
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $5,754.40 | Professional | None | $891.25 | $891.25 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $12,022.64 | Facility | None | $812.83 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,380.38 | Professional | None | $660.69 | $812.83 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $5,011.87 Typical High $6,456.54 | Facility | None | $1,122.02 | $5,011.87 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,412.54 | $1,584.89 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $588.84 Typical High $1,023.29 | Professional | None | $70.79 | $588.84 | $1,023.29 |
SummaCare Setting Facility Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $3,388.44 | Facility | None | $2,818.38 | $2,951.21 | $3,388.44 |
SummaCare Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,122.02 | Professional | None | $776.25 | $870.96 | $1,122.02 |
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 $575.44 Median $954.99 Typical High $1,659.59 | Professional | None | $575.44 | $954.99 | $1,659.59 |
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 $446.68 Median $446.68 Typical High $1,513.56 | Professional | 52 · Reduced service | $446.68 | $446.68 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $602.56 | Professional | 53 · Discontinued | $177.83 | $177.83 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $2,238.72 | Professional | 54 · Surgery only | $660.69 | $660.69 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $457.09 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $302.00 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,230.27 Typical High $2,041.74 | Professional | 50 · Both sides | $977.24 | $1,230.27 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $218.78 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $190.55 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $190.55 |
Where Ohio sits
The same service costs 17.4 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· 49th of 51
$692
AK $3,715TX $214
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.