How much rates vary
Facilitymedian $1,585 · 10th to 90th $447 to $10,233Professionalmedian $1,259 · 10th to 90th $123 to $1,995
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 $1,380.38 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,380.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $10,232.93 | Professional | None | $1,380.38 | $1,380.38 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,258.93 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,905.46 Typical High $3,090.30 | Professional | 50 · Both sides | $1,548.82 | $1,905.46 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $794.33 Typical High $1,318.26 | Professional | 62 · Two surgeons | $645.65 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $331.13 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,513.56 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,513.56 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $1,202.26 Typical High $1,621.81 | Professional | None | $107.15 | $1,202.26 | $1,621.81 |
SummaCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,348.96 | $2,344.23 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,621.81 | $3,715.35 |
7 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 $691.83 Median $691.83 Typical High $1,949.84 | Professional | 52 · Reduced service | $691.83 | $691.83 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $776.25 | Professional | 53 · Discontinued | $275.42 | $275.42 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $588.84 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $389.05 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $2,691.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $177.83 Typical High $288.40 | Professional | AS · PA/NP assist | $144.54 | $177.83 | $288.40 |
Where Ohio sits
The same service costs 4.8 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· 45th of 51
$1,288
AK $5,012TX $1,047
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.