How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $10,233Professionalmedian $1,585 · 10th to 90th $129 to $2,455
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 $1,819.70 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,819.70 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $10,232.93 | Professional | None | $1,819.70 | $1,819.70 | $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 $1,445.44 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,698.24 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,621.81 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,621.81 | $1,995.26 | $3,548.13 |
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 $1,621.81 Median $1,995.26 Typical High $3,981.07 | Professional | None | $1,621.81 | $1,995.26 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,348.96 Typical High $1,949.84 | Professional | None | $114.82 | $1,348.96 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,698.24 | $2,951.21 |
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 $1,698.24 Median $2,238.72 Typical High $4,786.30 | Professional | None | $1,698.24 | $2,238.72 | $4,786.30 |
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 $891.25 Median $891.25 Typical High $3,090.30 | Professional | 52 · Reduced service | $891.25 | $891.25 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $1,258.93 | Professional | 53 · Discontinued | $363.08 | $363.08 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $933.25 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $630.96 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,570.40 Typical High $3,890.45 | Professional | 50 · Both sides | $2,041.74 | $2,570.40 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $1,621.81 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $269.15 Typical High $436.52 | Professional | 80 · Assistant surgeon | $218.78 | $269.15 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $239.88 Typical High $363.08 | Professional | AS · PA/NP assist | $186.21 | $239.88 | $363.08 |
Where Ohio sits
The same service costs 5.8 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
$1,622
AK $6,457TX $1,122
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.