How much rates vary
Facilitymedian $3,467 · 10th to 90th $676 to $11,220Professionalmedian $1,380 · 10th to 90th $214 to $2,344
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 $2,691.53 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,691.53 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $9,120.11 | Professional | None | $1,737.80 | $1,737.80 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $7,585.78 | Facility | None | $645.65 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,348.96 | $2,398.83 |
CareSource Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,467.37 Typical High $5,888.44 | Facility | None | $549.54 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,238.72 | $2,951.21 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,467.37 Typical High $5,623.41 | Facility | None | $549.54 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,238.72 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,230.27 Typical High $2,137.96 | Professional | None | $177.83 | $1,230.27 | $2,137.96 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,819.70 | $2,290.87 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,096.48 | $1,621.81 | $3,162.28 |
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 $870.96 Median $870.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $537.03 | Professional | 53 · Discontinued | $346.74 | $346.74 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $407.38 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $269.15 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $851.14 Typical High $1,513.56 | Professional | 62 · Two surgeons | $676.08 | $851.14 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $213.80 Typical High $380.19 | Professional | 80 · Assistant surgeon | $173.78 | $213.80 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $190.55 Typical High $338.84 | Professional | AS · PA/NP assist | $151.36 | $190.55 | $338.84 |
Where Ohio sits
The same service costs 11.2 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· 49th of 51
$1,413
AK $7,244TX $646
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.