How much rates vary
Facilitymedian $3,548 · 10th to 90th $501 to $16,596Professionalmedian $891 · 10th to 90th $93 to $1,349
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $9,120.11 | Professional | None | $954.99 | $954.99 | $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 $741.31 Median $891.25 Typical High $1,479.11 | Professional | None | $741.31 | $891.25 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $831.76 Median $1,047.13 Typical High $1,949.84 | Professional | None | $831.76 | $1,047.13 | $1,949.84 |
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 $831.76 Median $1,047.13 Typical High $1,949.84 | Professional | None | $831.76 | $1,047.13 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $794.33 Typical High $1,230.27 | Professional | None | $81.28 | $794.33 | $1,230.27 |
SummaCare Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,348.96 | Professional | None | $870.96 | $870.96 | $1,348.96 |
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 $912.01 Median $1,096.48 Typical High $2,290.87 | Professional | None | $912.01 | $1,096.48 | $2,290.87 |
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 $467.74 Median $467.74 Typical High $1,548.82 | Professional | 52 · Reduced service | $467.74 | $467.74 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $630.96 | Professional | 53 · Discontinued | $190.55 | $190.55 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $2,344.23 | Professional | 54 · Surgery only | $707.95 | $707.95 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $467.74 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $316.23 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,348.96 Typical High $2,238.72 | Professional | 50 · Both sides | $1,122.02 | $1,348.96 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $562.34 Typical High $933.25 | Professional | 62 · Two surgeons | $467.74 | $562.34 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $245.47 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $208.93 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $208.93 |
Where Ohio sits
The same service costs 7.9 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
$912
AK $3,802TX $479
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.