How much rates vary
Facilitymedian $3,236 · 10th to 90th $501 to $12,303Professionalmedian $891 · 10th to 90th $91 to $1,288
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 $891.25 Median $891.25 Typical High $9,120.11 | Professional | None | $891.25 | $891.25 | $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 $691.83 Median $851.14 Typical High $1,380.38 | Professional | None | $691.83 | $851.14 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $776.25 Median $977.24 Typical High $1,819.70 | Professional | None | $776.25 | $977.24 | $1,819.70 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,819.70 | Professional | None | $776.25 | $977.24 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $831.76 Typical High $1,174.90 | Professional | None | $79.43 | $831.76 | $1,174.90 |
SummaCare Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,258.93 | Professional | None | $812.83 | $812.83 | $1,258.93 |
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 $851.14 Median $1,023.29 Typical High $2,137.96 | Professional | None | $851.14 | $1,023.29 | $2,137.96 |
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 $446.68 Median $446.68 Typical High $1,479.11 | Professional | 52 · Reduced service | $446.68 | $446.68 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $588.84 | Professional | 53 · Discontinued | $177.83 | $177.83 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $2,187.76 | Professional | 54 · Surgery only | $660.69 | $660.69 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $436.52 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $295.12 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,258.93 Typical High $2,041.74 | Professional | 50 · Both sides | $1,023.29 | $1,258.93 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $549.54 Typical High $851.14 | Professional | 62 · Two surgeons | $436.52 | $549.54 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $134.90 Typical High $223.87 | Professional | 80 · Assistant surgeon | $109.65 | $134.90 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $117.49 Typical High $194.98 | Professional | AS · PA/NP assist | $95.50 | $117.49 | $194.98 |
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· 47th of 51
$891
AK $3,548UT $631
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.