How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $10,965Professionalmedian $955 · 10th to 90th $135 to $1,585
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $6,025.60 | Professional | None | $1,174.90 | $1,174.90 | $6,025.60 |
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 $954.99 Median $1,174.90 Typical High $1,819.70 | Professional | None | $954.99 | $1,174.90 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $5,011.87 | Facility | None | $588.84 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,548.82 | $2,344.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $4,897.79 | Facility | None | $588.84 | $2,951.21 | $4,897.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,548.82 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $758.58 Typical High $1,318.26 | Professional | None | $107.15 | $758.58 | $1,318.26 |
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 $1,023.29 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,122.02 | $1,479.11 |
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 $776.25 Median $1,288.25 Typical High $2,238.72 | Professional | None | $776.25 | $1,288.25 | $2,238.72 |
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 $588.84 Median $588.84 Typical High $2,691.53 | Professional | 52 · Reduced service | $588.84 | $588.84 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $1,071.52 | Professional | 53 · Discontinued | $234.42 | $234.42 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $3,981.07 | Professional | 54 · Surgery only | $891.25 | $891.25 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $794.33 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $537.03 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $741.31 Typical High $1,148.15 | Professional | 62 · Two surgeons | $602.56 | $741.31 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $190.55 Typical High $288.40 | Professional | 80 · Assistant surgeon | $151.36 | $190.55 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $165.96 Typical High $257.04 | Professional | AS · PA/NP assist | $131.83 | $165.96 | $257.04 |
Where Ohio sits
The same service costs 14.5 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
$977
AK $4,898TX $339
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.