How much rates vary
Facilitymedian $3,388 · 10th to 90th $794 to $10,233Professionalmedian $1,072 · 10th to 90th $135 to $1,698
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 $1,174.90 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 $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 $891.25 Median $1,071.52 Typical High $1,819.70 | Professional | None | $891.25 | $1,071.52 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $4,677.35 | Facility | None | $1,445.44 | $3,548.13 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,630.78 Typical High $6,165.95 | Facility | None | $741.31 | $3,630.78 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,202.26 | $2,398.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,630.78 Typical High $5,754.40 | Facility | None | $741.31 | $3,630.78 | $5,754.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,174.90 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $977.24 Typical High $1,513.56 | Professional | None | $120.23 | $977.24 | $1,513.56 |
SummaCare Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,344.23 | Facility | None | $1,995.26 | $2,089.30 | $2,344.23 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,096.48 | $1,621.81 |
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 $954.99 Median $1,258.93 Typical High $2,691.53 | Professional | None | $954.99 | $1,258.93 | $2,691.53 |
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 $1,905.46 | Professional | 52 · Reduced service | $588.84 | $588.84 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $758.58 | Professional | 53 · Discontinued | $234.42 | $234.42 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $2,884.03 | Professional | 54 · Surgery only | $891.25 | $891.25 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $575.44 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $380.19 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,621.81 Typical High $2,691.53 | Professional | 50 · Both sides | $1,348.96 | $1,621.81 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $676.08 Typical High $1,148.15 | Professional | 62 · Two surgeons | $562.34 | $676.08 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $302.00 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $257.04 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $257.04 |
Where Ohio sits
The same service costs 6.6 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
$1,122
AK $4,898TX $741
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.