How much rates vary
Facilitymedian $5,129 · 10th to 90th $871 to $13,804Professionalmedian $933 · 10th to 90th $174 to $1,622
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $5,370.32 | Professional | None | $1,258.93 | $1,258.93 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,981.07 Typical High $19,054.61 | Facility | None | $891.25 | $3,981.07 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,621.81 | Professional | None | $645.65 | $758.58 | $1,621.81 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $9,120.11 Typical High $11,748.98 | Facility | None | $1,584.89 | $9,120.11 | $11,748.98 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,317.64 Typical High $13,489.63 | Facility | None | $741.31 | $8,317.64 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,621.81 | $2,290.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $8,317.64 Typical High $13,182.57 | Facility | None | $741.31 | $8,317.64 | $13,182.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,621.81 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $831.76 Typical High $1,445.44 | Professional | None | $141.25 | $831.76 | $1,445.44 |
SummaCare Setting Facility Modifier None Typical Low $4,570.88 Median $4,786.30 Typical High $5,495.41 | Facility | None | $4,570.88 | $4,786.30 | $5,495.41 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,230.27 | $1,584.89 |
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 $794.33 Median $1,348.96 Typical High $2,290.87 | Professional | None | $794.33 | $1,348.96 | $2,290.87 |
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 $630.96 Median $630.96 Typical High $2,344.23 | Professional | 52 · Reduced service | $630.96 | $630.96 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $933.25 | Professional | 53 · Discontinued | $251.19 | $251.19 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $3,548.13 | Professional | 54 · Surgery only | $933.25 | $933.25 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $707.95 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $467.74 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,148.15 Typical High $2,454.71 | Professional | 50 · Both sides | $977.24 | $1,148.15 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $1,023.29 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $263.03 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $229.09 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $229.09 |
Where Ohio sits
The same service costs 7.4 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
$955
AK $5,248TX $708
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.