How much rates vary
Facilitymedian $4,074 · 10th to 90th $851 to $11,482Professionalmedian $759 · 10th to 90th $85 to $1,380
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 $1,071.52 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,071.52 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $4,897.79 | Professional | None | $1,071.52 | $1,071.52 | $4,897.79 |
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 $524.81 Median $616.60 Typical High $1,380.38 | Professional | None | $524.81 | $616.60 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,398.83 | Facility | None | $1,230.27 | $1,621.81 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $549.54 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,380.38 | $1,949.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $549.54 | $4,466.84 | $7,079.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,380.38 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $676.08 Typical High $1,202.26 | Professional | None | $70.79 | $676.08 | $1,202.26 |
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 $933.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $933.25 | $1,047.13 | $1,348.96 |
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 $676.08 Median $1,096.48 Typical High $1,949.84 | Professional | None | $676.08 | $1,096.48 | $1,949.84 |
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 $537.03 Median $537.03 Typical High $2,238.72 | Professional | 52 · Reduced service | $537.03 | $537.03 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $891.25 | Professional | 53 · Discontinued | $213.80 | $213.80 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $3,388.44 | Professional | 54 · Surgery only | $794.33 | $794.33 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $676.08 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $446.68 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $933.25 Typical High $2,041.74 | Professional | 50 · Both sides | $776.25 | $933.25 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $218.78 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $87.10 Typical High $190.55 | Professional | AS · PA/NP assist | $72.44 | $87.10 | $190.55 |
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· 49th of 51
$776
AK $4,467TX $324
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.