How much rates vary
Facilitymedian $5,248 · 10th to 90th $794 to $14,454Professionalmedian $1,585 · 10th to 90th $257 to $2,630
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 $3,090.30 Median $10,232.93 Typical High $19,498.45 | Facility | None | $3,090.30 | $10,232.93 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $7,762.47 | Professional | None | $1,949.84 | $1,949.84 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $7,762.47 | Facility | None | $645.65 | $1,778.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,698.24 | $2,818.38 |
CareSource Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $9,332.54 Typical High $15,135.61 | Facility | None | $588.84 | $9,332.54 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,511.89 | $3,715.35 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $9,332.54 Typical High $14,454.40 | Facility | None | $588.84 | $9,332.54 | $14,454.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,511.89 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $1,288.25 Typical High $2,290.87 | Professional | None | $213.80 | $1,288.25 | $2,290.87 |
SummaCare Setting Facility Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,888.44 | Facility | None | $4,897.79 | $5,128.61 | $5,888.44 |
SummaCare Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,778.28 | $1,995.26 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,230.27 | $2,041.74 | $3,548.13 |
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 $977.24 Median $977.24 Typical High $2,041.74 | Professional | 52 · Reduced service | $977.24 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $831.76 | Professional | 53 · Discontinued | $389.05 | $389.05 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $616.60 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $416.87 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,071.52 Typical High $1,778.28 | Professional | 62 · Two surgeons | $851.14 | $1,071.52 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $269.15 Typical High $457.09 | Professional | 80 · Assistant surgeon | $218.78 | $269.15 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $239.88 Typical High $407.38 | Professional | AS · PA/NP assist | $190.55 | $239.88 | $407.38 |
Where Ohio sits
The same service costs 16.2 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
$1,622
AK $8,128TX $501
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.