How much rates vary
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 $2,290.87 Median $2,290.87 Typical High $7,762.47 | Professional | None | $2,290.87 | $2,290.87 | $7,762.47 |
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 $1,348.96 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,698.24 | $3,019.95 |
CareSource Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $13,489.63 Typical High $21,379.62 | Facility | None | $588.84 | $13,489.63 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,951.21 | $3,715.35 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $13,489.63 Typical High $20,892.96 | Facility | None | $588.84 | $13,489.63 | $20,892.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,344.23 | $2,951.21 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,380.38 Typical High $2,570.40 | Professional | None | $194.98 | $1,380.38 | $2,570.40 |
SummaCare Setting Facility Modifier None Typical Low $7,244.36 Median $7,585.78 Typical High $8,511.38 | Facility | None | $7,244.36 | $7,585.78 | $8,511.38 |
SummaCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,290.87 | $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 $1,445.44 Median $2,187.76 Typical High $4,168.69 | Professional | None | $1,445.44 | $2,187.76 | $4,168.69 |
4 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 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $3,981.07 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $3,981.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $269.15 Typical High $489.78 | Professional | 80 · Assistant surgeon | $213.80 | $269.15 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $234.42 Typical High $426.58 | Professional | AS · PA/NP assist | $186.21 | $234.42 | $426.58 |
Where Ohio sits
The same service costs 14.8 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
$1,698
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.