How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $9,120Professionalmedian $776 · 10th to 90th $126 to $1,288
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 $977.24 Median $977.24 Typical High $5,754.40 | Professional | None | $977.24 | $977.24 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,348.96 | Professional | None | $630.96 | $794.33 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,230.27 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $2,691.53 | Facility | None | $562.34 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,698.24 | Professional | None | $977.24 | $1,288.25 | $1,698.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,698.24 | Professional | None | $977.24 | $1,288.25 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $630.96 Typical High $1,122.02 | Professional | None | $104.71 | $630.96 | $1,122.02 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,230.27 | Professional | None | $851.14 | $933.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,862.09 | Professional | None | $630.96 | $977.24 | $1,862.09 |
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 $489.78 Median $489.78 Typical High $1,584.89 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $630.96 | Professional | 53 · Discontinued | $194.98 | $194.98 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $2,398.83 | Professional | 54 · Surgery only | $724.44 | $724.44 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $478.63 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $316.23 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,202.26 Typical High $2,041.74 | Professional | 50 · Both sides | $954.99 | $1,202.26 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $125.89 Typical High $218.78 | Professional | 80 · Assistant surgeon | $102.33 | $125.89 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $112.20 Typical High $194.98 | Professional | AS · PA/NP assist | $89.13 | $112.20 | $194.98 |
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
$794
AK $3,981TX $525
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.