How much rates vary
Facilitymedian $2,455 · 10th to 90th $813 to $10,233Professionalmedian $1,047 · 10th to 90th $145 to $1,660
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 $1,318.26 Median $1,318.26 Typical High $10,232.93 | Professional | None | $1,318.26 | $1,318.26 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,762.47 | Facility | None | $794.33 | $1,778.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,737.80 | Professional | None | $891.25 | $1,047.13 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,511.89 | Facility | None | $1,584.89 | $1,949.84 | $2,511.89 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,344.23 Typical High $3,801.89 | Facility | None | $794.33 | $2,344.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,995.26 | Professional | None | $954.99 | $1,348.96 | $1,995.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $2,344.23 Typical High $3,801.89 | Facility | None | $851.14 | $2,344.23 | $3,801.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,995.26 | Professional | None | $954.99 | $1,348.96 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $794.33 Typical High $1,380.38 | Professional | None | $102.33 | $794.33 | $1,380.38 |
SummaCare Setting Facility Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $2,691.53 | Facility | None | $2,290.87 | $2,398.83 | $2,691.53 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,258.93 | $2,290.87 |
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 $660.69 Median $660.69 Typical High $1,995.26 | Professional | 52 · Reduced service | $660.69 | $660.69 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $794.33 | Professional | 53 · Discontinued | $263.03 | $263.03 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $602.56 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $398.11 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,548.82 Typical High $2,630.27 | Professional | 50 · Both sides | $1,318.26 | $1,548.82 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $1,096.48 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $295.12 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $245.47 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $245.47 |
Where Ohio sits
The same service costs 7.1 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 $5,370UT $759
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.