How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,047 to $12,023Professionalmedian $447 · 10th to 90th $316 to $676
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 $1,174.90 Median $7,762.47 Typical High $15,848.93 | Facility | None | $1,174.90 | $7,762.47 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $10,232.93 | Professional | None | $446.68 | $446.68 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $9,549.93 | Facility | None | $954.99 | $2,754.23 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $676.08 | Professional | None | $323.59 | $389.05 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $2,754.23 Typical High $3,630.78 | Facility | None | $524.81 | $2,754.23 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,235.94 Typical High $6,025.60 | Facility | None | $1,318.26 | $3,235.94 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $891.25 | Professional | None | $407.38 | $467.74 | $891.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,318.26 Median $3,235.94 Typical High $6,025.60 | Facility | None | $1,318.26 | $3,235.94 | $6,025.60 |
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 $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $602.56 | Professional | None | $407.38 | $407.38 | $602.56 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,000.00 | Professional | None | $380.19 | $478.63 | $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 $218.78 Median $218.78 Typical High $794.33 | Professional | 52 · Reduced service | $218.78 | $218.78 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $316.23 | Professional | 53 · Discontinued | $89.13 | $89.13 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $331.13 | $331.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $239.88 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $158.49 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $588.84 Typical High $1,000.00 | Professional | 50 · Both sides | $489.78 | $588.84 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $204.17 Median $251.19 Typical High $426.58 | Professional | 62 · Two surgeons | $204.17 | $251.19 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $63.10 Typical High $107.15 | Professional | 80 · Assistant surgeon | $52.48 | $63.10 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $54.95 Typical High $93.33 | Professional | AS · PA/NP assist | $45.71 | $54.95 | $93.33 |
Where Ohio sits
The same service costs 9.5 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 $339
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.