How much rates vary
Facilitymedian $3,631 · 10th to 90th $676 to $10,965Professionalmedian $955 · 10th to 90th $135 to $1,549
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $9,120.11 | Professional | None | $1,148.15 | $1,148.15 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,949.84 | Professional | None | $954.99 | $1,174.90 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $7,585.78 | Facility | None | $588.84 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,513.56 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $7,079.46 | Facility | None | $588.84 | $4,570.88 | $7,079.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,513.56 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $724.44 Typical High $1,258.93 | Professional | None | $107.15 | $724.44 | $1,258.93 |
SummaCare Setting Facility Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,398.83 | $2,511.89 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,412.54 | Professional | None | $977.24 | $1,096.48 | $1,412.54 |
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 $741.31 Median $1,288.25 Typical High $2,187.76 | Professional | None | $741.31 | $1,288.25 | $2,187.76 |
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 $575.44 Median $575.44 Typical High $1,949.84 | Professional | 52 · Reduced service | $575.44 | $575.44 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $776.25 | Professional | 53 · Discontinued | $229.09 | $229.09 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $2,951.21 | Professional | 54 · Surgery only | $870.96 | $870.96 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $588.84 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $389.05 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,778.28 Typical High $2,818.38 | Professional | 50 · Both sides | $1,412.54 | $1,778.28 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $741.31 Typical High $1,202.26 | Professional | 62 · Two surgeons | $602.56 | $741.31 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $199.53 Typical High $954.99 | Professional | 80 · Assistant surgeon | $151.36 | $199.53 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $165.96 Typical High $269.15 | Professional | AS · PA/NP assist | $131.83 | $165.96 | $269.15 |
Where Ohio sits
The same service costs 8.7 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
$955
AK $4,786TX $550
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.