How much rates vary
Facilitymedian $1,514 · 10th to 90th $708 to $9,772Professionalmedian $794 · 10th to 90th $95 to $1,230
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $10,232.93 | Professional | None | $977.24 | $977.24 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $4,786.30 | Facility | None | $630.96 | $1,202.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,348.96 | Professional | None | $707.95 | $831.76 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,513.56 | Facility | None | $1,174.90 | $1,174.90 | $1,513.56 |
CareSource Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,348.96 Typical High $3,388.44 | Facility | None | $794.33 | $1,348.96 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,548.82 | Professional | None | $691.83 | $1,023.29 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $1,348.96 Typical High $3,388.44 | Facility | None | $851.14 | $1,348.96 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,548.82 | Professional | None | $691.83 | $1,023.29 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $602.56 Typical High $1,000.00 | Professional | None | $69.18 | $602.56 | $1,000.00 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $776.25 | Facility | None | $645.65 | $676.08 | $776.25 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,230.27 | Professional | None | $851.14 | $851.14 | $1,230.27 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,778.28 | Professional | None | $812.83 | $977.24 | $1,778.28 |
9 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 $489.78 Median $489.78 Typical High $1,584.89 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $630.96 | Professional | 53 · Discontinued | $194.98 | $194.98 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $2,344.23 | Professional | 54 · Surgery only | $741.31 | $741.31 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $467.74 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $316.23 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,995.26 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $234.42 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $190.55 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $190.55 |
Where Ohio sits
The same service costs 7.2 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· 47th of 51
$832
AK $3,981UT $550
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.