How much rates vary
Facilitymedian $5,623 · 10th to 90th $646 to $16,218Professionalmedian $776 · 10th to 90th $132 to $1,175
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 $2,884.03 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,884.03 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $10,232.93 | Professional | None | $794.33 | $794.33 | $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 $660.69 Median $776.25 Typical High $1,288.25 | Professional | None | $660.69 | $776.25 | $1,288.25 |
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 $707.95 Median $1,047.13 Typical High $1,698.24 | Professional | None | $707.95 | $1,047.13 | $1,698.24 |
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 $707.95 Median $1,047.13 Typical High $1,698.24 | Professional | None | $707.95 | $1,047.13 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $660.69 Typical High $1,023.29 | Professional | None | $120.23 | $660.69 | $1,023.29 |
SummaCare Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,148.15 | Professional | None | $741.31 | $741.31 | $1,148.15 |
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 $741.31 Median $977.24 Typical High $2,041.74 | Professional | None | $741.31 | $977.24 | $2,041.74 |
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 $398.11 Median $398.11 Typical High $1,445.44 | Professional | 52 · Reduced service | $398.11 | $398.11 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $575.44 | Professional | 53 · Discontinued | $158.49 | $158.49 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $2,137.96 | Professional | 54 · Surgery only | $602.56 | $602.56 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $426.58 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $288.40 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,174.90 Typical High $1,905.46 | Professional | 50 · Both sides | $1,000.00 | $1,174.90 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $489.78 Typical High $831.76 | Professional | 62 · Two surgeons | $416.87 | $489.78 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $208.93 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $181.97 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $181.97 |
Where Ohio sits
The same service costs 6.2 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
$776
AK $3,311UT $537
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.