How much rates vary
Facilitymedian $1,622 · 10th to 90th $447 to $10,233Professionalmedian $1,380 · 10th to 90th $123 to $2,138
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 $1,584.89 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,584.89 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $10,232.93 | Professional | None | $1,584.89 | $1,584.89 | $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 $1,148.15 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,380.38 | $2,238.72 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,412.54 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,737.80 | $3,162.28 |
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 $1,412.54 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,737.80 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,230.27 Typical High $1,737.80 | Professional | None | $114.82 | $1,230.27 | $1,737.80 |
SummaCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,412.54 | $1,548.82 | $2,691.53 |
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 $1,479.11 Median $1,862.09 Typical High $4,265.80 | Professional | None | $1,479.11 | $1,862.09 | $4,265.80 |
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 $794.33 Median $794.33 Typical High $2,754.23 | Professional | 52 · Reduced service | $794.33 | $794.33 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $1,096.48 | Professional | 53 · Discontinued | $316.23 | $316.23 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $4,073.80 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $831.76 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $549.54 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,089.30 Typical High $3,388.44 | Professional | 50 · Both sides | $1,737.80 | $2,089.30 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $891.25 Typical High $1,412.54 | Professional | 62 · Two surgeons | $724.44 | $891.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $363.08 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $194.98 Typical High $316.23 | Professional | AS · PA/NP assist | $162.18 | $194.98 | $316.23 |
Where Ohio sits
The same service costs 5.6 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· 46th of 51
$1,413
AK $5,754TX $1,023
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.