How much rates vary
Facilitymedian $1,122 · 10th to 90th $513 to $5,248Professionalmedian $457 · 10th to 90th $89 to $794
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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $3,548.13 | Professional | None | $616.60 | $616.60 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,466.84 | Facility | None | $524.81 | $1,174.90 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $794.33 | Professional | None | $331.13 | $416.87 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $69.18 Typical High $331.13 | Professional | 80 · Assistant surgeon | $53.70 | $69.18 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,047.13 | Facility | None | $776.25 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $933.25 Typical High $1,995.26 | Facility | None | $489.78 | $933.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,047.13 | Professional | None | $616.60 | $794.33 | $1,047.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,995.26 | Facility | None | $512.86 | $933.25 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,047.13 | Professional | None | $616.60 | $794.33 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $416.87 Typical High $724.44 | Professional | None | $70.79 | $416.87 | $724.44 |
SummaCare Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Facility | None | $446.68 | $467.74 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $794.33 | Professional | None | $549.54 | $602.56 | $794.33 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $1,122.02 | Professional | None | $389.05 | $562.34 | $1,122.02 |
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 $309.03 Median $309.03 Typical High $1,071.52 | Professional | 52 · Reduced service | $309.03 | $309.03 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $426.58 | Professional | 53 · Discontinued | $123.03 | $123.03 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $1,584.89 | Professional | 54 · Surgery only | $457.09 | $457.09 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $316.23 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $213.80 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $1,479.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $57.54 Typical High $112.20 | Professional | AS · PA/NP assist | $46.77 | $57.54 | $112.20 |
Where Ohio sits
The same service costs 7.4 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
$479
AK $2,570TX $347
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.