How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $12,589Professionalmedian $912 · 10th to 90th $91 to $1,380
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 $912.01 Median $912.01 Typical High $9,120.11 | Professional | None | $912.01 | $912.01 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,489.63 | Facility | None | $891.25 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,479.11 | Professional | None | $724.44 | $912.01 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $812.83 Median $1,000.00 Typical High $1,862.09 | Professional | None | $812.83 | $1,000.00 | $1,862.09 |
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 $812.83 Median $1,000.00 Typical High $1,862.09 | Professional | None | $812.83 | $1,000.00 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $891.25 Typical High $1,230.27 | Professional | None | $79.43 | $891.25 | $1,230.27 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,318.26 | Professional | None | $851.14 | $851.14 | $1,318.26 |
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 $891.25 Median $1,071.52 Typical High $2,238.72 | Professional | None | $891.25 | $1,071.52 | $2,238.72 |
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 $457.09 Median $457.09 Typical High $1,548.82 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $616.60 | Professional | 53 · Discontinued | $186.21 | $186.21 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,290.87 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $457.09 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $309.03 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $2,238.72 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $575.44 Typical High $933.25 | Professional | 62 · Two surgeons | $457.09 | $575.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $147.91 Typical High $245.47 | Professional | 80 · Assistant surgeon | $117.49 | $147.91 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $208.93 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $208.93 |
Where Ohio sits
The same service costs 5.6 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
$933
AK $3,715UT $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.