How much rates vary
Facilitymedian $1,738 · 10th to 90th $562 to $8,128Professionalmedian $1,023 · 10th to 90th $123 to $1,585
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 $1,862.09 Median $4,570.88 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,570.88 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $5,128.61 | Professional | None | $1,047.13 | $1,047.13 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,737.80 | Professional | None | $912.01 | $1,122.02 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,445.44 | Facility | None | $891.25 | $1,174.90 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,000.00 Typical High $1,995.26 | Facility | None | $489.78 | $1,000.00 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,513.56 | $2,137.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,995.26 | Facility | None | $512.86 | $1,000.00 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,513.56 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $891.25 Typical High $1,380.38 | Professional | None | $100.00 | $891.25 | $1,380.38 |
SummaCare Setting Facility Modifier None Typical Low $489.78 Median $512.86 Typical High $588.84 | Facility | None | $489.78 | $512.86 | $588.84 |
SummaCare Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,412.54 | Professional | None | $977.24 | $1,096.48 | $1,412.54 |
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 $1,230.27 Typical High $2,137.96 | Professional | None | $741.31 | $1,230.27 | $2,137.96 |
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 $524.81 Median $524.81 Typical High $2,187.76 | Professional | 52 · Reduced service | $524.81 | $524.81 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $870.96 | Professional | 53 · Discontinued | $208.93 | $208.93 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $3,311.31 | Professional | 54 · Surgery only | $794.33 | $794.33 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $660.69 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $436.52 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,630.27 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $707.95 Typical High $1,096.48 | Professional | 62 · Two surgeons | $575.44 | $707.95 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $181.97 Typical High $281.84 | Professional | 80 · Assistant surgeon | $144.54 | $181.97 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $251.19 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $251.19 |
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
$1,047
AK $4,786UT $776
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.