How much rates vary
Facilitymedian $4,786 · 10th to 90th $955 to $12,023Professionalmedian $2,089 · 10th to 90th $302 to $3,388
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 $2,951.21 Median $8,709.64 Typical High $13,803.84 | Facility | None | $2,951.21 | $8,709.64 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $10,471.29 | Professional | None | $2,570.40 | $2,570.40 | $10,471.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,467.37 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,570.40 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $5,011.87 Typical High $8,511.38 | Facility | None | $588.84 | $5,011.87 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $4,897.79 | Professional | None | $2,630.27 | $3,388.44 | $4,897.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $5,011.87 Typical High $8,511.38 | Facility | None | $588.84 | $5,011.87 | $8,511.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $4,786.30 | Professional | None | $2,630.27 | $3,388.44 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $1,621.81 Typical High $2,818.38 | Professional | None | $251.19 | $1,621.81 | $2,818.38 |
SummaCare Setting Facility Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,398.83 | $2,511.89 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,398.83 | $3,162.28 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,818.38 Typical High $4,897.79 | Professional | None | $1,659.59 | $2,818.38 | $4,897.79 |
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 $1,288.25 Median $1,288.25 Typical High $4,897.79 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $1,949.84 | Professional | 53 · Discontinued | $512.86 | $512.86 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $7,413.10 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $1,479.11 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $977.24 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,621.81 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,318.26 | $1,621.81 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $416.87 Typical High $645.65 | Professional | 80 · Assistant surgeon | $331.13 | $416.87 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $363.08 Typical High $562.34 | Professional | AS · PA/NP assist | $288.40 | $363.08 | $562.34 |
Where Ohio sits
The same service costs 8.7 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· 48th of 51
$2,089
AK $10,715TX $1,230
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.