How much rates vary
Facilitymedian $8,710 · 10th to 90th $1,023 to $23,442Professionalmedian $1,288 · 10th to 90th $195 to $1,950
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 $1,258.93 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,258.93 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $5,011.87 | Professional | None | $1,258.93 | $1,258.93 | $5,011.87 |
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 $1,023.29 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,288.25 | $2,137.96 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,047.13 Typical High $6,760.83 | Facility | None | $426.58 | $1,047.13 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,778.28 | $2,511.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $1,122.02 Typical High $6,760.83 | Facility | None | $426.58 | $1,122.02 | $6,760.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,778.28 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,148.15 Typical High $1,819.70 | Professional | None | $165.96 | $1,148.15 | $1,819.70 |
SummaCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,412.54 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,570.88 Typical High $13,803.84 | Facility | None | $1,071.52 | $4,570.88 | $13,803.84 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,511.89 | Professional | None | $870.96 | $1,445.44 | $2,511.89 |
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 $630.96 Median $630.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $851.14 | Professional | 53 · Discontinued | $251.19 | $251.19 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $3,235.94 | Professional | 54 · Surgery only | $954.99 | $954.99 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $645.65 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $426.58 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,905.46 Typical High $3,162.28 | Professional | 50 · Both sides | $1,548.82 | $1,905.46 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | 62 · Two surgeons | $645.65 | $812.83 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $338.84 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $177.83 Typical High $302.00 | Professional | AS · PA/NP assist | $144.54 | $177.83 | $302.00 |
Where Ohio sits
The same service costs 5.9 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· 48th of 51
$1,288
AK $5,754TX $977
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.