How much rates vary
Facilitymedian $2,884 · 10th to 90th $912 to $10,715Professionalmedian $589 · 10th to 90th $89 to $955
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 $3,548.13 Median $10,000.00 Typical High $13,803.84 | Facility | None | $3,548.13 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $8,317.64 | Professional | None | $707.95 | $707.95 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $7,943.28 | Facility | None | $912.01 | $2,238.72 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,047.13 | Professional | None | $512.86 | $630.96 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $3,548.13 Typical High $4,677.35 | Facility | None | $912.01 | $3,548.13 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,047.13 | $3,235.94 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,318.26 | Professional | None | $741.31 | $954.99 | $1,318.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,071.52 | $3,235.94 | $5,248.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,230.27 | Professional | None | $741.31 | $954.99 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $489.78 Typical High $851.14 | Professional | None | $70.79 | $489.78 | $851.14 |
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 $630.96 Median $707.95 Typical High $912.01 | Professional | None | $630.96 | $707.95 | $912.01 |
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 $478.63 Median $776.25 Typical High $1,348.96 | Professional | None | $478.63 | $776.25 | $1,348.96 |
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 $354.81 Median $354.81 Typical High $2,290.87 | Professional | 52 · Reduced service | $354.81 | $354.81 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $912.01 | Professional | 53 · Discontinued | $144.54 | $144.54 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $3,388.44 | Professional | 54 · Surgery only | $537.03 | $537.03 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $676.08 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $457.09 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $102.33 Typical High $173.78 | Professional | 80 · Assistant surgeon | $81.28 | $102.33 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $89.13 Typical High $151.36 | Professional | AS · PA/NP assist | $70.79 | $89.13 | $151.36 |
Where Ohio sits
The same service costs 17.4 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
$617
AK $3,020TX $174
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.