How much rates vary
Facilitymedian $3,802 · 10th to 90th $832 to $10,965Professionalmedian $759 · 10th to 90th $89 to $1,259
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 $933.25 Median $933.25 Typical High $6,606.93 | Professional | None | $933.25 | $933.25 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,467.37 Typical High $12,022.64 | Facility | None | $891.25 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,513.56 | Professional | None | $741.31 | $912.01 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,202.26 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,888.44 | Facility | None | $741.31 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,737.80 | Professional | None | $954.99 | $1,230.27 | $1,737.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,623.41 | Facility | None | $741.31 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,737.80 | Professional | None | $954.99 | $1,230.27 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $602.56 Typical High $1,071.52 | Professional | None | $70.79 | $602.56 | $1,071.52 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,174.90 | Professional | None | $831.76 | $912.01 | $1,174.90 |
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 $602.56 Median $1,023.29 Typical High $1,737.80 | Professional | None | $602.56 | $1,023.29 | $1,737.80 |
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 $467.74 Median $467.74 Typical High $1,584.89 | Professional | 52 · Reduced service | $467.74 | $467.74 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $630.96 | Professional | 53 · Discontinued | $186.21 | $186.21 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $2,344.23 | Professional | 54 · Surgery only | $707.95 | $707.95 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $467.74 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $316.23 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $2,238.72 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $575.44 Typical High $954.99 | Professional | 62 · Two surgeons | $457.09 | $575.44 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $147.91 Typical High $245.47 | Professional | 80 · Assistant surgeon | $117.49 | $147.91 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $213.80 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $213.80 |
Where Ohio sits
The same service costs 7.9 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
$776
AK $3,981TX $501
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.