How much rates vary
Facilitymedian $5,623 · 10th to 90th $646 to $16,218Professionalmedian $851 · 10th to 90th $135 to $1,259
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 $707.95 Median $851.14 Typical High $1,412.54 | Professional | None | $707.95 | $851.14 | $1,412.54 |
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 $1,148.15 Typical High $1,778.28 | Professional | None | $794.33 | $1,148.15 | $1,778.28 |
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 $1,148.15 Typical High $1,819.70 | Professional | None | $794.33 | $1,148.15 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $707.95 Typical High $1,096.48 | Professional | None | $120.23 | $707.95 | $1,096.48 |
SummaCare Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,230.27 | Professional | None | $812.83 | $812.83 | $1,230.27 |
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 $2,238.72 | Professional | None | $812.83 | $1,071.52 | $2,238.72 |
9 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 $1,995.26 | Professional | 52 · Reduced service | $446.68 | $446.68 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $794.33 | Professional | 53 · Discontinued | $177.83 | $177.83 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $2,951.21 | Professional | 54 · Surgery only | $660.69 | $660.69 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $588.84 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $398.11 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $2,041.74 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $229.09 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $194.98 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $194.98 |
Where Ohio sits
The same service costs 6.5 times more in Alaska than in Texas. 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
$851
AK $3,715TX $575
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.