How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,023 to $14,454Professionalmedian $1,995 · 10th to 90th $263 to $3,162
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 $3,548.13 Median $10,232.93 Typical High $19,498.45 | Facility | None | $3,548.13 | $10,232.93 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $8,128.31 | Professional | None | $2,398.83 | $2,398.83 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,467.37 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,344.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $380.19 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $302.00 | $380.19 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $8,912.51 Typical High $14,791.08 | Facility | None | $588.84 | $8,912.51 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,454.71 | $3,162.28 | $4,897.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $9,120.11 Typical High $14,125.38 | Facility | None | $588.84 | $9,120.11 | $14,125.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,454.71 | $3,162.28 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $1,621.81 Typical High $2,691.53 | Professional | None | $239.88 | $1,621.81 | $2,691.53 |
SummaCare Setting Facility Modifier None Typical Low $4,786.30 Median $5,011.87 Typical High $5,623.41 | Facility | None | $4,786.30 | $5,011.87 | $5,623.41 |
SummaCare Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,238.72 | $2,951.21 |
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 $1,548.82 Median $2,691.53 Typical High $4,677.35 | Professional | None | $1,548.82 | $2,691.53 | $4,677.35 |
8 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 $1,202.26 Median $1,202.26 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $1,122.02 | Professional | 53 · Discontinued | $478.63 | $478.63 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $4,168.69 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $851.14 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $562.34 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,479.11 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,174.90 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $331.13 Typical High $524.81 | Professional | AS · PA/NP assist | $263.03 | $331.13 | $524.81 |
Where Ohio sits
The same service costs 25.7 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
$1,995
AK $10,000TX $389
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.