How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,072 to $12,023Professionalmedian $708 · 10th to 90th $89 to $1,175
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 $870.96 Median $870.96 Typical High $6,025.60 | Professional | None | $870.96 | $870.96 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,548.13 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,412.54 | Professional | None | $660.69 | $812.83 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,011.87 Typical High $7,762.47 | Facility | None | $707.95 | $5,011.87 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $891.25 | $1,122.02 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,047.13 Median $5,011.87 Typical High $7,585.78 | Facility | None | $1,047.13 | $5,011.87 | $7,585.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $891.25 | $1,122.02 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $562.34 Typical High $1,000.00 | Professional | None | $70.79 | $562.34 | $1,000.00 |
SummaCare Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,884.03 | Facility | None | $2,454.71 | $2,570.40 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,096.48 | Professional | None | $758.58 | $851.14 | $1,096.48 |
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 $562.34 Median $933.25 Typical High $1,621.81 | Professional | None | $562.34 | $933.25 | $1,621.81 |
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 $436.52 Median $436.52 Typical High $1,778.28 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $707.95 | Professional | 53 · Discontinued | $173.78 | $173.78 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $2,691.53 | Professional | 54 · Surgery only | $645.65 | $645.65 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $537.03 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $354.81 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,230.27 Typical High $2,089.30 | Professional | 50 · Both sides | $977.24 | $1,230.27 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $512.86 Typical High $891.25 | Professional | 62 · Two surgeons | $416.87 | $512.86 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $144.54 Typical High $660.69 | Professional | 80 · Assistant surgeon | $104.71 | $144.54 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $199.53 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $199.53 |
Where Ohio sits
The same service costs 13.8 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· 47th of 51
$741
AK $3,631TX $263
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.