How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $12,589Professionalmedian $1,230 · 10th to 90th $138 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 $1,230.27 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,230.27 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $9,120.11 | Professional | None | $1,230.27 | $1,230.27 | $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 $933.25 Median $1,202.26 Typical High $1,995.26 | Professional | None | $933.25 | $1,202.26 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,071.52 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,348.96 | $2,511.89 |
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 $1,071.52 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,348.96 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,148.15 Typical High $1,659.59 | Professional | None | $123.03 | $1,148.15 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,122.02 | $1,737.80 |
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 $1,148.15 Median $1,412.54 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,412.54 | $2,951.21 |
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 $602.56 Median $602.56 Typical High $1,995.26 | Professional | 52 · Reduced service | $602.56 | $602.56 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $794.33 | Professional | 53 · Discontinued | $245.47 | $245.47 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $3,019.95 | Professional | 54 · Surgery only | $912.01 | $912.01 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $602.56 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $398.11 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,819.70 Typical High $2,951.21 | Professional | 50 · Both sides | $1,380.38 | $1,819.70 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $758.58 Typical High $1,258.93 | Professional | 62 · Two surgeons | $588.84 | $758.58 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $199.53 Typical High $346.74 | Professional | 80 · Assistant surgeon | $147.91 | $199.53 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $165.96 Typical High $281.84 | Professional | AS · PA/NP assist | $128.82 | $165.96 | $281.84 |
Where Ohio sits
The same service costs 5.9 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· 48th of 51
$1,230
AK $4,898TX $832
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.