How much rates vary
Facilitymedian $3,162 · 10th to 90th $741 to $9,333Professionalmedian $447 · 10th to 90th $316 to $661
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 $2,238.72 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,238.72 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $9,120.11 | Professional | None | $446.68 | $446.68 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $7,762.47 | Facility | None | $691.83 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $645.65 | Professional | None | $323.59 | $389.05 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $3,090.30 Typical High $3,981.07 | Facility | None | $524.81 | $3,090.30 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,311.31 Typical High $5,370.32 | Facility | None | $691.83 | $3,311.31 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $870.96 | Professional | None | $407.38 | $467.74 | $870.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $5,128.61 | Facility | None | $741.31 | $3,311.31 | $5,128.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $891.25 | Professional | None | $407.38 | $467.74 | $891.25 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $446.68 Typical High $602.56 | Professional | None | $57.54 | $446.68 | $602.56 |
SummaCare Setting Facility Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,089.30 | Facility | None | $1,737.80 | $1,819.70 | $2,089.30 |
SummaCare Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $616.60 | Professional | None | $407.38 | $407.38 | $616.60 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $1,000.00 | Professional | None | $380.19 | $489.78 | $1,000.00 |
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 $223.87 Median $223.87 Typical High $933.25 | Professional | 52 · Reduced service | $223.87 | $223.87 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $371.54 | Professional | 53 · Discontinued | $89.13 | $89.13 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $1,380.38 | Professional | 54 · Surgery only | $331.13 | $331.13 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $281.84 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $186.21 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $575.44 Typical High $954.99 | Professional | 50 · Both sides | $489.78 | $575.44 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $204.17 Median $245.47 Typical High $398.11 | Professional | 62 · Two surgeons | $204.17 | $245.47 | $398.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $61.66 Typical High $102.33 | Professional | 80 · Assistant surgeon | $52.48 | $61.66 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $53.70 Typical High $91.20 | Professional | AS · PA/NP assist | $45.71 | $53.70 | $91.20 |
Where Ohio sits
The same service costs 9.8 times more in Oklahoma 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
$468
OK $3,236UT $331
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.