How much rates vary
Facilitymedian $3,467 · 10th to 90th $501 to $11,749Professionalmedian $1,148 · 10th to 90th $112 to $1,820
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 $1,348.96 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,348.96 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $10,232.93 | Professional | None | $1,348.96 | $1,348.96 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $6,025.60 Typical High $12,589.25 | Facility | None | $1,071.52 | $6,025.60 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,905.46 | Professional | None | $812.83 | $1,047.13 | $1,905.46 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $1,202.26 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,513.56 | $2,630.27 |
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 $1,202.26 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,513.56 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $1,096.48 Typical High $1,479.11 | Professional | None | $97.72 | $1,096.48 | $1,479.11 |
SummaCare Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,258.93 | $2,187.76 |
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 $1,258.93 Median $1,584.89 Typical High $3,630.78 | Professional | None | $1,258.93 | $1,584.89 | $3,630.78 |
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 $676.08 Median $676.08 Typical High $1,949.84 | Professional | 52 · Reduced service | $676.08 | $676.08 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $776.25 | Professional | 53 · Discontinued | $269.15 | $269.15 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $575.44 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $389.05 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,584.89 Typical High $2,818.38 | Professional | 50 · Both sides | $1,230.27 | $1,584.89 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $660.69 Typical High $1,202.26 | Professional | 62 · Two surgeons | $512.86 | $660.69 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $169.82 Typical High $309.03 | Professional | 80 · Assistant surgeon | $131.83 | $169.82 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $147.91 Typical High $263.03 | Professional | AS · PA/NP assist | $114.82 | $147.91 | $263.03 |
Where Ohio sits
The same service costs 5.2 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· 47th of 51
$1,202
AK $4,786TX $912
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.