How much rates vary
Facilitymedian $3,715 · 10th to 90th $501 to $16,596Professionalmedian $1,047 · 10th to 90th $93 to $1,585
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 $1,096.48 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,096.48 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $9,120.11 | Professional | None | $1,096.48 | $1,096.48 | $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 $812.83 Median $1,000.00 Typical High $1,659.59 | Professional | None | $812.83 | $1,000.00 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $1,023.29 Median $1,202.26 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,202.26 | $2,137.96 |
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 $1,023.29 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,202.26 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $954.99 Typical High $1,479.11 | Professional | None | $81.28 | $954.99 | $1,479.11 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,047.13 | $1,584.89 |
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 $1,000.00 Median $1,230.27 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,230.27 | $2,630.27 |
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 $549.54 Median $549.54 Typical High $1,778.28 | Professional | 52 · Reduced service | $549.54 | $549.54 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $707.95 | Professional | 53 · Discontinued | $218.78 | $218.78 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $2,691.53 | Professional | 54 · Surgery only | $812.83 | $812.83 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $537.03 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $354.81 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,513.56 Typical High $2,454.71 | Professional | 50 · Both sides | $1,202.26 | $1,513.56 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $630.96 Typical High $1,047.13 | Professional | 62 · Two surgeons | $512.86 | $630.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $158.49 Typical High $263.03 | Professional | 80 · Assistant surgeon | $128.82 | $158.49 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $141.25 Typical High $234.42 | Professional | AS · PA/NP assist | $112.20 | $141.25 | $234.42 |
Where Ohio sits
The same service costs 6.6 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
$1,072
AK $4,365TX $661
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.