How much rates vary
Facilitymedian $3,715 · 10th to 90th $501 to $16,596Professionalmedian $1,413 · 10th to 90th $138 to $2,089
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 $1,445.44 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,445.44 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $9,120.11 | Professional | None | $1,445.44 | $1,445.44 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $19,952.62 | Facility | None | $1,047.13 | $7,943.28 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,412.54 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,258.93 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,584.89 | $2,951.21 |
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 $1,258.93 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,584.89 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,348.96 Typical High $1,905.46 | Professional | None | $123.03 | $1,348.96 | $1,905.46 |
SummaCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,348.96 | $2,089.30 |
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 $1,380.38 Median $1,698.24 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,698.24 | $3,467.37 |
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 $724.44 Median $724.44 Typical High $2,398.83 | Professional | 52 · Reduced service | $724.44 | $724.44 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $954.99 | Professional | 53 · Discontinued | $288.40 | $288.40 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $707.95 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $478.63 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,137.96 Typical High $3,388.44 | Professional | 50 · Both sides | $1,737.80 | $2,137.96 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $891.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $724.44 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $223.87 Typical High $389.05 | Professional | 80 · Assistant surgeon | $181.97 | $223.87 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $199.53 Typical High $323.59 | Professional | AS · PA/NP assist | $162.18 | $199.53 | $323.59 |
Where Ohio sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$1,445
AK $5,888UT $1,000
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.