How much rates vary
Facilitymedian $1,698 · 10th to 90th $617 to $7,762Professionalmedian $646 · 10th to 90th $95 to $1,047
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 $2,089.30 Median $5,754.40 Typical High $12,022.64 | Facility | None | $2,089.30 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $7,079.46 | Professional | None | $776.25 | $776.25 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,202.26 | Professional | None | $645.65 | $758.58 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,513.56 | Facility | None | $933.25 | $1,174.90 | $1,513.56 |
CareSource Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,380.38 Typical High $6,025.60 | Facility | None | $549.54 | $1,380.38 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,584.89 | Professional | None | $562.34 | $831.76 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,380.38 Typical High $6,025.60 | Facility | None | $549.54 | $1,380.38 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,584.89 | Professional | None | $562.34 | $831.76 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $467.74 Typical High $794.33 | Professional | None | $69.18 | $467.74 | $794.33 |
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 $691.83 Median $691.83 Typical High $1,047.13 | Professional | None | $691.83 | $691.83 | $1,047.13 |
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 $724.44 Median $851.14 Typical High $1,412.54 | Professional | None | $724.44 | $851.14 | $1,412.54 |
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 $389.05 Median $389.05 Typical High $1,230.27 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $489.78 | Professional | 53 · Discontinued | $158.49 | $158.49 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $1,862.09 | Professional | 54 · Surgery only | $588.84 | $588.84 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $371.54 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $245.47 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,148.15 Typical High $1,819.70 | Professional | 50 · Both sides | $977.24 | $1,148.15 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $194.98 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $173.78 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $173.78 |
Where Ohio sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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.
Physician feeFacility fee
OK $7,181MS $1,948
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.