How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $9,333Professionalmedian $562 · 10th to 90th $102 to $891
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 $1,412.54 Median $6,918.31 Typical High $12,589.25 | Facility | None | $1,412.54 | $6,918.31 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $3,981.07 | Professional | None | $512.86 | $602.56 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $4,786.30 | Facility | None | $645.65 | $1,348.96 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $870.96 | Professional | None | $478.63 | $588.84 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,691.53 | Facility | None | $645.65 | $2,089.30 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $2,290.87 Typical High $4,677.35 | Facility | None | $1,047.13 | $2,290.87 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,122.02 | Professional | None | $575.44 | $707.95 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,071.52 Median $2,290.87 Typical High $4,677.35 | Facility | None | $1,071.52 | $2,290.87 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,122.02 | Professional | None | $575.44 | $707.95 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $457.09 Typical High $794.33 | Professional | None | $70.79 | $457.09 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,318.26 | Facility | None | $1,122.02 | $1,174.90 | $1,318.26 |
SummaCare Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $758.58 | Professional | None | $489.78 | $616.60 | $758.58 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $1,122.02 | Professional | None | $416.87 | $676.08 | $1,122.02 |
8 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 $257.04 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $257.04 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $102.33 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $380.19 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $104.71 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $60.26 Typical High $69.18 | Professional | 56 · Pre-op care only | $51.29 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $354.81 | $416.87 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $95.50 Typical High $478.63 | Professional | 80 · Assistant surgeon | $75.86 | $95.50 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $83.18 Typical High $123.03 | Professional | AS · PA/NP assist | $66.07 | $83.18 | $123.03 |
Where Ohio sits
The same service costs 6.2 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
$575
AK $2,570TX $417
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.