How much rates vary
Facilitymedian $4,677 · 10th to 90th $513 to $23,442Professionalmedian $1,318 · 10th to 90th $209 to $2,188
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 $2,398.83 Median $5,011.87 Typical High $12,589.25 | Facility | None | $2,398.83 | $5,011.87 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $7,943.28 | Professional | None | $1,318.26 | $1,318.26 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $12,022.64 Typical High $28,183.83 | Facility | None | $1,479.11 | $12,022.64 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,288.25 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,862.09 | $3,090.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,862.09 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,230.27 Typical High $1,995.26 | Professional | None | $199.53 | $1,230.27 | $1,995.26 |
SummaCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,445.44 | $2,187.76 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,380.38 | $1,862.09 | $3,548.13 |
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 $660.69 Median $660.69 Typical High $3,019.95 | Professional | 52 · Reduced service | $660.69 | $660.69 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $1,202.26 | Professional | 53 · Discontinued | $263.03 | $263.03 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $4,570.88 | Professional | 54 · Surgery only | $977.24 | $977.24 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $912.01 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $602.56 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,949.84 Typical High $3,388.44 | Professional | 50 · Both sides | $1,659.59 | $1,949.84 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $812.83 Typical High $1,445.44 | Professional | 62 · Two surgeons | $691.83 | $812.83 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $363.08 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $323.59 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $323.59 |
Where Ohio sits
The same service costs 7.8 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
$1,380
AK $5,888TX $759
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.