How much rates vary
Facilitymedian $5,623 · 10th to 90th $646 to $16,218Professionalmedian $851 · 10th to 90th $135 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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $10,232.93 | Professional | None | $891.25 | $891.25 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $19,498.45 | Facility | None | $1,047.13 | $7,943.28 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,445.44 | Professional | None | $758.58 | $891.25 | $1,445.44 |
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 $794.33 Median $1,174.90 Typical High $1,862.09 | Professional | None | $794.33 | $1,174.90 | $1,862.09 |
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 $794.33 Median $1,174.90 Typical High $1,862.09 | Professional | None | $794.33 | $1,174.90 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $741.31 Typical High $1,122.02 | Professional | None | $120.23 | $741.31 | $1,122.02 |
SummaCare Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,258.93 | Professional | None | $831.76 | $831.76 | $1,258.93 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,290.87 | Professional | None | $812.83 | $1,071.52 | $2,290.87 |
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 $2,630.27 | Professional | 52 · Reduced service | $446.68 | $446.68 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $1,047.13 | Professional | 53 · Discontinued | $177.83 | $177.83 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $3,890.45 | Professional | 54 · Surgery only | $660.69 | $660.69 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $776.25 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $524.81 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,318.26 Typical High $2,137.96 | Professional | 50 · Both sides | $1,122.02 | $1,318.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $912.01 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $229.09 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $204.17 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $204.17 |
Where Ohio sits
The same service costs 6.3 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· 48th of 51
$891
AK $3,715UT $589
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.