How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $10,715Professionalmedian $1,698 · 10th to 90th $148 to $2,570
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 $1,737.80 Median $1,737.80 Typical High $10,232.93 | Professional | None | $1,737.80 | $1,737.80 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,778.28 | $2,951.21 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,348.96 Typical High $2,290.87 | Facility | None | $891.25 | $1,348.96 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,884.03 Typical High $5,011.87 | Facility | None | $562.34 | $2,884.03 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,584.89 | $1,905.46 | $3,801.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $575.44 Median $2,884.03 Typical High $4,897.79 | Facility | None | $575.44 | $2,884.03 | $4,897.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,584.89 | $1,905.46 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $1,412.54 Typical High $2,238.72 | Professional | None | $125.89 | $1,412.54 | $2,238.72 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,659.59 | $1,659.59 | $2,630.27 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,089.30 | $4,168.69 |
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 $870.96 Median $870.96 Typical High $3,090.30 | Professional | 52 · Reduced service | $870.96 | $870.96 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $1,230.27 | Professional | 53 · Discontinued | $346.74 | $346.74 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $933.25 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $616.60 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,691.53 Typical High $4,365.16 | Professional | 50 · Both sides | $2,290.87 | $2,691.53 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $281.84 Typical High $467.74 | Professional | 80 · Assistant surgeon | $239.88 | $281.84 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $251.19 Typical High $407.38 | Professional | AS · PA/NP assist | $213.80 | $251.19 | $407.38 |
Where Ohio sits
The same service costs 6.9 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· 47th of 51
$1,738
AK $7,586TX $1,096
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.