How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $10,233Professionalmedian $1,288 · 10th to 90th $219 to $2,239
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 $2,754.23 Median $8,709.64 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,709.64 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $9,332.54 | Professional | None | $1,621.81 | $1,621.81 | $9,332.54 |
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 $1,174.90 Median $1,479.11 Typical High $4,897.79 | Professional | None | $1,174.90 | $1,479.11 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $269.15 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $190.55 | $269.15 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,715.35 Typical High $6,165.95 | Facility | None | $588.84 | $3,715.35 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,621.81 | $2,137.96 | $3,162.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $3,801.89 Typical High $5,754.40 | Facility | None | $588.84 | $3,801.89 | $5,754.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,137.96 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,047.13 Typical High $1,819.70 | Professional | None | $177.83 | $1,047.13 | $1,819.70 |
SummaCare Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,344.23 | Facility | None | $1,995.26 | $2,089.30 | $2,344.23 |
SummaCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,548.82 | $2,041.74 |
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 $1,071.52 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,778.28 | $3,090.30 |
7 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 $812.83 Median $812.83 Typical High $4,466.84 | Professional | 52 · Reduced service | $812.83 | $812.83 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $1,778.28 | Professional | 53 · Discontinued | $323.59 | $323.59 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $6,606.93 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $1,318.26 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $891.25 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $6,165.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $660.69 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $660.69 |
Where Ohio sits
The same service costs 18.2 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· 47th of 51
$1,318
AK $6,918TX $380
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.