How much rates vary
Facilitymedian $5,129 · 10th to 90th $646 to $16,218Professionalmedian $617 · 10th to 90th $93 to $1,000
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 $2,454.71 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,454.71 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $9,120.11 | Professional | None | $691.83 | $691.83 | $9,120.11 |
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 $489.78 Median $602.56 Typical High $1,023.29 | Professional | None | $489.78 | $602.56 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,584.89 Typical High $2,398.83 | Facility | None | $870.96 | $1,584.89 | $2,398.83 |
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 $616.60 Median $912.01 Typical High $1,479.11 | Professional | None | $616.60 | $912.01 | $1,479.11 |
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 $616.60 Median $912.01 Typical High $1,479.11 | Professional | None | $616.60 | $912.01 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $562.34 Typical High $891.25 | Professional | None | $81.28 | $562.34 | $891.25 |
SummaCare Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Professional | None | $645.65 | $645.65 | $1,023.29 |
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 $630.96 Median $812.83 Typical High $1,778.28 | Professional | None | $630.96 | $812.83 | $1,778.28 |
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 $346.74 Median $346.74 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $524.81 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $912.01 Typical High $1,513.56 | Professional | 50 · Both sides | $741.31 | $912.01 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $380.19 Typical High $645.65 | Professional | 62 · Two surgeons | $309.03 | $380.19 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $97.72 Typical High $162.18 | Professional | 80 · Assistant surgeon | $79.43 | $97.72 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $85.11 Typical High $141.25 | Professional | AS · PA/NP assist | $69.18 | $85.11 | $141.25 |
Where Ohio sits
The same service costs 6.9 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· 46th of 51
$661
AK $2,884TX $417
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.