How much rates vary
Facilitymedian $1,660 · 10th to 90th $457 to $6,918Professionalmedian $550 · 10th to 90th $87 to $891
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 $1,380.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $2,630.27 | Professional | None | $645.65 | $645.65 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,513.56 Typical High $7,585.78 | Facility | None | $537.03 | $1,513.56 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,047.13 | Professional | None | $501.19 | $630.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $104.71 Typical High $501.19 | Professional | 80 · Assistant surgeon | $81.28 | $104.71 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $1,995.26 | Facility | None | $812.83 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,621.81 Typical High $2,511.89 | Facility | None | $363.08 | $1,621.81 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,202.26 | Professional | None | $630.96 | $794.33 | $1,202.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,621.81 Typical High $2,454.71 | Facility | None | $389.05 | $1,621.81 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,174.90 | Professional | None | $630.96 | $794.33 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $457.09 Typical High $794.33 | Professional | None | $70.79 | $457.09 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $870.96 | Professional | None | $602.56 | $676.08 | $870.96 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $398.11 Median $676.08 Typical High $1,174.90 | Professional | None | $398.11 | $676.08 | $1,174.90 |
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 $323.59 Median $323.59 Typical High $1,000.00 | Professional | 52 · Reduced service | $323.59 | $323.59 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $407.38 | Professional | 53 · Discontinued | $128.82 | $128.82 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $1,513.56 | Professional | 54 · Surgery only | $489.78 | $489.78 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $302.00 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $204.17 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $1,412.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $89.13 Typical High $147.91 | Professional | AS · PA/NP assist | $70.79 | $89.13 | $147.91 |
Where Ohio sits
The same service costs 7.8 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· 47th of 51
$562
AK $2,754TX $355
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.