How much rates vary
Facilitymedian $2,951 · 10th to 90th $776 to $10,233Professionalmedian $1,096 · 10th to 90th $135 to $1,660
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 $1,148.15 Median $1,148.15 Typical High $8,912.51 | Professional | None | $1,148.15 | $1,148.15 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $7,762.47 | Facility | None | $758.58 | $2,238.72 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,737.80 | Professional | None | $933.25 | $1,096.48 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,412.54 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,019.95 Typical High $4,897.79 | Facility | None | $676.08 | $3,019.95 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $2,691.53 | Professional | None | $1,000.00 | $1,148.15 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $691.83 Median $3,019.95 Typical High $4,570.88 | Facility | None | $691.83 | $3,019.95 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $2,691.53 | Professional | None | $1,000.00 | $1,148.15 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $933.25 Typical High $1,479.11 | Professional | None | $120.23 | $933.25 | $1,479.11 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,047.13 | $1,905.46 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,348.96 | $2,630.27 |
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 $575.44 Median $575.44 Typical High $2,398.83 | Professional | 52 · Reduced service | $575.44 | $575.44 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $977.24 | Professional | 53 · Discontinued | $229.09 | $229.09 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $3,630.78 | Professional | 54 · Surgery only | $851.14 | $851.14 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $724.44 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $489.78 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,621.81 Typical High $2,630.27 | Professional | 50 · Both sides | $1,380.38 | $1,621.81 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $1,096.48 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $295.12 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $251.19 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $251.19 |
Where Ohio sits
The same service costs 6.8 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· 48th of 51
$1,096
AK $4,786TX $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.