How much rates vary
Facilitymedian $3,548 · 10th to 90th $501 to $20,893Professionalmedian $891 · 10th to 90th $148 to $1,445
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,570.88 | Professional | None | $1,000.00 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $9,772.37 Typical High $22,908.68 | Facility | None | $1,047.13 | $9,772.37 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,479.11 | Professional | None | $616.60 | $776.25 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $1,071.52 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,412.54 | $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 $1,096.48 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,412.54 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $794.33 Typical High $1,348.96 | Professional | None | $134.90 | $794.33 | $1,348.96 |
SummaCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,122.02 | $1,380.38 |
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 $676.08 Median $1,023.29 Typical High $1,949.84 | Professional | None | $676.08 | $1,023.29 | $1,949.84 |
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 $501.19 Median $501.19 Typical High $1,995.26 | Professional | 52 · Reduced service | $501.19 | $501.19 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $794.33 | Professional | 53 · Discontinued | $199.53 | $199.53 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $2,951.21 | Professional | 54 · Surgery only | $741.31 | $741.31 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $588.84 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $398.11 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,174.90 Typical High $2,238.72 | Professional | 50 · Both sides | $933.25 | $1,174.90 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $489.78 Typical High $933.25 | Professional | 62 · Two surgeons | $389.05 | $489.78 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $125.89 Typical High $239.88 | Professional | 80 · Assistant surgeon | $100.00 | $125.89 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $109.65 Typical High $208.93 | Professional | AS · PA/NP assist | $87.10 | $109.65 | $208.93 |
Where Ohio sits
The same service costs 21.9 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
$891
AK $4,467TX $204
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.