How much rates vary
Facilitymedian $5,370 · 10th to 90th $871 to $13,804Professionalmedian $1,000 · 10th to 90th $135 to $1,622
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 $1,230.27 Median $1,230.27 Typical High $6,606.93 | Professional | None | $1,230.27 | $1,230.27 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $19,054.61 | Facility | None | $891.25 | $3,890.45 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,862.09 | Professional | None | $912.01 | $1,122.02 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $9,120.11 Typical High $11,748.98 | Facility | None | $1,548.82 | $9,120.11 | $11,748.98 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $9,120.11 Typical High $14,454.40 | Facility | None | $741.31 | $9,120.11 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,584.89 | $2,290.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $9,120.11 Typical High $14,454.40 | Facility | None | $741.31 | $9,120.11 | $14,454.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,584.89 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $812.83 Typical High $1,412.54 | Professional | None | $107.15 | $812.83 | $1,412.54 |
SummaCare Setting Facility Modifier None Typical Low $5,011.87 Median $5,248.07 Typical High $5,888.44 | Facility | None | $5,011.87 | $5,248.07 | $5,888.44 |
SummaCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,174.90 | $1,548.82 |
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 $776.25 Median $1,318.26 Typical High $2,238.72 | Professional | None | $776.25 | $1,318.26 | $2,238.72 |
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 $616.60 Median $616.60 Typical High $2,570.40 | Professional | 52 · Reduced service | $616.60 | $616.60 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $1,023.29 | Professional | 53 · Discontinued | $245.47 | $245.47 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $3,801.89 | Professional | 54 · Surgery only | $912.01 | $912.01 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $776.25 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $512.86 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,754.23 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $707.95 Typical High $1,148.15 | Professional | 62 · Two surgeons | $575.44 | $707.95 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $181.97 Typical High $912.01 | Professional | 80 · Assistant surgeon | $144.54 | $181.97 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $263.03 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $263.03 |
Where Ohio sits
The same service costs 7.6 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
$1,023
AK $5,129TX $676
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.