How much rates vary
Facilitymedian $3,802 · 10th to 90th $692 to $11,220Professionalmedian $933 · 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 $1,174.90 Median $1,174.90 Typical High $9,120.11 | Professional | None | $1,174.90 | $1,174.90 | $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 $891.25 Median $1,096.48 Typical High $1,819.70 | Professional | None | $891.25 | $1,096.48 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,677.35 Typical High $7,762.47 | Facility | None | $588.84 | $4,677.35 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,548.82 | $2,238.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $4,677.35 Typical High $7,244.36 | Facility | None | $588.84 | $4,677.35 | $7,244.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,548.82 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $758.58 Typical High $1,348.96 | Professional | None | $107.15 | $758.58 | $1,348.96 |
SummaCare Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,951.21 | Facility | None | $2,454.71 | $2,570.40 | $2,951.21 |
SummaCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,148.15 | $1,479.11 |
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 $758.58 Median $1,258.93 Typical High $2,187.76 | Professional | None | $758.58 | $1,258.93 | $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 $588.84 Median $588.84 Typical High $1,995.26 | Professional | 52 · Reduced service | $588.84 | $588.84 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $794.33 | Professional | 53 · Discontinued | $234.42 | $234.42 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $3,019.95 | Professional | 54 · Surgery only | $891.25 | $891.25 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $602.56 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $398.11 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,659.59 Typical High $2,691.53 | Professional | 50 · Both sides | $1,318.26 | $1,659.59 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $691.83 Typical High $1,122.02 | Professional | 62 · Two surgeons | $562.34 | $691.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $186.21 Typical High $891.25 | Professional | 80 · Assistant surgeon | $141.25 | $186.21 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $154.88 Typical High $257.04 | Professional | AS · PA/NP assist | $123.03 | $154.88 | $257.04 |
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 $5,012TX $575
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.