How much rates vary
Facilitymedian $3,981 · 10th to 90th $955 to $10,965Professionalmedian $1,288 · 10th to 90th $214 to $2,138
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 $5,754.40 Typical High $12,022.64 | Facility | None | $2,344.23 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $7,943.28 | Professional | None | $1,584.89 | $1,584.89 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,801.89 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,584.89 | $2,570.40 |
Aultcare Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $4,365.16 | Facility | None | $2,041.74 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,467.37 Typical High $5,888.44 | Facility | None | $549.54 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,089.30 | $3,019.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,467.37 Typical High $5,623.41 | Facility | None | $549.54 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,659.59 | $2,089.30 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,023.29 Typical High $1,778.28 | Professional | None | $177.83 | $1,023.29 | $1,778.28 |
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 $1,380.38 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,513.56 | $1,995.26 |
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 $1,023.29 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,023.29 | $1,737.80 | $3,019.95 |
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 $794.33 Median $794.33 Typical High $3,715.35 | Professional | 52 · Reduced service | $794.33 | $794.33 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $1,513.56 | Professional | 53 · Discontinued | $316.23 | $316.23 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $5,623.41 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $1,122.02 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $758.58 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,344.23 Typical High $3,801.89 | Professional | 50 · Both sides | $1,862.09 | $2,344.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $977.24 Typical High $1,621.81 | Professional | 62 · Two surgeons | $794.33 | $977.24 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $269.15 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $199.53 | $269.15 | $1,258.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $218.78 Typical High $363.08 | Professional | AS · PA/NP assist | $173.78 | $218.78 | $363.08 |
Where Ohio sits
The same service costs 7.8 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
$1,318
AK $6,761TX $871
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.