How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $10,233Professionalmedian $1,072 · 10th to 90th $135 to $1,778
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 $1,348.96 Median $1,348.96 Typical High $6,606.93 | Professional | None | $1,348.96 | $1,348.96 | $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 $954.99 Median $1,202.26 Typical High $1,949.84 | Professional | None | $954.99 | $1,202.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $954.99 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $2,398.83 | Facility | None | $1,230.27 | $1,737.80 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,801.89 Typical High $6,165.95 | Facility | None | $588.84 | $3,801.89 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,778.28 | $2,454.71 |
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 $1,380.38 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,778.28 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $891.25 Typical High $1,513.56 | Professional | None | $107.15 | $891.25 | $1,513.56 |
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 $1,148.15 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,288.25 | $1,659.59 |
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 $891.25 Median $1,445.44 Typical High $2,570.40 | Professional | None | $891.25 | $1,445.44 | $2,570.40 |
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 $676.08 Median $676.08 Typical High $2,884.03 | Professional | 52 · Reduced service | $676.08 | $676.08 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $870.96 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $575.44 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $4,073.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $275.42 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $275.42 |
Where Ohio sits
The same service costs 20.0 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
$1,096
AK $5,754TX $288
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.