How much rates vary
Facilitymedian $3,388 · 10th to 90th $724 to $10,233Professionalmedian $1,230 · 10th to 90th $178 to $2,089
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 $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $6,606.93 | Professional | None | $1,584.89 | $1,584.89 | $6,606.93 |
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 $1,230.27 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,548.82 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $251.19 Typical High $416.87 | Professional | 80 · Assistant surgeon | $199.53 | $251.19 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $4,677.35 | Facility | None | $1,995.26 | $3,548.13 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,630.78 Typical High $6,165.95 | Facility | None | $549.54 | $3,630.78 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,584.89 | $2,089.30 | $3,019.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,630.78 Typical High $5,754.40 | Facility | None | $549.54 | $3,630.78 | $5,754.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,584.89 | $2,089.30 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $977.24 Typical High $1,698.24 | Professional | None | $144.54 | $977.24 | $1,698.24 |
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 $1,318.26 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,445.44 | $1,905.46 |
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 $1,023.29 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,023.29 | $1,698.24 | $3,019.95 |
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 $794.33 Median $794.33 Typical High $2,951.21 | Professional | 52 · Reduced service | $794.33 | $794.33 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $1,174.90 | Professional | 53 · Discontinued | $316.23 | $316.23 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $870.96 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $588.84 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $4,073.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $218.78 Typical High $363.08 | Professional | AS · PA/NP assist | $173.78 | $218.78 | $363.08 |
Where Ohio sits
The same service costs 20.4 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
$1,259
AK $6,607TX $324
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.