How much rates vary
Facilitymedian $3,890 · 10th to 90th $708 to $11,220Professionalmedian $1,047 · 10th to 90th $135 to $1,778
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $8,912.51 | Professional | None | $1,348.96 | $1,348.96 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $7,585.78 | Facility | None | $645.65 | $1,737.80 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,089.30 | Professional | None | $954.99 | $1,202.26 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $213.80 Typical High $954.99 | Professional | 80 · Assistant surgeon | $154.88 | $213.80 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $7,585.78 | Facility | None | $588.84 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,778.28 | $2,630.27 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $7,079.46 | Facility | None | $588.84 | $4,570.88 | $7,079.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,778.28 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $851.14 Typical High $1,513.56 | Professional | None | $107.15 | $851.14 | $1,513.56 |
SummaCare Setting Facility Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,398.83 | $2,511.89 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,288.25 | $1,698.24 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,511.89 | Professional | None | $870.96 | $1,445.44 | $2,511.89 |
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 $676.08 Median $676.08 Typical High $2,884.03 | Professional | 52 · Reduced service | $676.08 | $676.08 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $870.96 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $575.44 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $4,073.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $165.96 Typical High $288.40 | Professional | AS · PA/NP assist | $134.90 | $165.96 | $288.40 |
Where Ohio sits
The same service costs 18.6 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
$1,072
AK $5,623TX $302
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.