How much rates vary
Facilitymedian $1,820 · 10th to 90th $603 to $8,128Professionalmedian $759 · 10th to 90th $78 to $1,148
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 $776.25 Median $776.25 Typical High $9,120.11 | Professional | None | $776.25 | $776.25 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $7,585.78 | Facility | None | $602.56 | $1,513.56 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,202.26 | Professional | None | $616.60 | $741.31 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,089.30 | Facility | None | $954.99 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $2,818.38 | Facility | None | $549.54 | $1,819.70 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,584.89 | Professional | None | $691.83 | $851.14 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $2,754.23 | Facility | None | $549.54 | $1,819.70 | $2,754.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,584.89 | Professional | None | $691.83 | $851.14 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $707.95 Typical High $1,023.29 | Professional | None | $63.10 | $707.95 | $1,023.29 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,096.48 | Professional | None | $724.44 | $724.44 | $1,096.48 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,862.09 | Professional | None | $741.31 | $912.01 | $1,862.09 |
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 $389.05 Median $389.05 Typical High $1,479.11 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $588.84 | Professional | 53 · Discontinued | $154.88 | $154.88 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $588.84 | $588.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $446.68 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $295.12 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,122.02 Typical High $1,778.28 | Professional | 50 · Both sides | $933.25 | $1,122.02 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $467.74 Typical High $758.58 | Professional | 62 · Two surgeons | $389.05 | $467.74 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $117.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $97.72 | $117.49 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $104.71 Typical High $169.82 | Professional | AS · PA/NP assist | $87.10 | $104.71 | $169.82 |
Where Ohio sits
The same service costs 5.8 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· 49th of 51
$776
AK $3,162UT $550
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.