How much rates vary
Facilitymedian $2,884 · 10th to 90th $724 to $9,120Professionalmedian $871 · 10th to 90th $132 to $1,514
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 $1,949.84 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,949.84 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $4,570.88 | Professional | None | $1,122.02 | $1,122.02 | $4,570.88 |
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 $190.55 Median $1,148.15 Typical High $1,659.59 | Professional | None | $190.55 | $1,148.15 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,884.03 Typical High $4,897.79 | Facility | None | $562.34 | $2,884.03 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,513.56 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,884.03 Typical High $4,570.88 | Facility | None | $602.56 | $2,884.03 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,513.56 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $691.83 Typical High $1,202.26 | Professional | None | $107.15 | $691.83 | $1,202.26 |
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 $954.99 Median $1,047.13 Typical High $1,348.96 | Professional | None | $954.99 | $1,047.13 | $1,348.96 |
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 $758.58 Median $1,258.93 Typical High $2,187.76 | Professional | None | $758.58 | $1,258.93 | $2,187.76 |
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 $549.54 Median $549.54 Typical High $1,995.26 | Professional | 52 · Reduced service | $549.54 | $549.54 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $794.33 | Professional | 53 · Discontinued | $223.87 | $223.87 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $3,019.95 | Professional | 54 · Surgery only | $831.76 | $831.76 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $602.56 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $398.11 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $120.23 Median $724.44 Typical High $1,047.13 | Professional | 62 · Two surgeons | $120.23 | $724.44 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $186.21 Typical High $269.15 | Professional | 80 · Assistant surgeon | $31.62 | $186.21 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.30 Median $162.18 Typical High $234.42 | Professional | AS · PA/NP assist | $26.30 | $162.18 | $234.42 |
Where Ohio sits
The same service costs 16.6 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
$912
AK $4,677TX $282
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.