How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $9,120Professionalmedian $562 · 10th to 90th $89 to $933
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $5,754.40 | Professional | None | $691.83 | $691.83 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,122.02 | Professional | None | $524.81 | $645.65 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,995.26 | Facility | None | $891.25 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,288.25 | Professional | None | $707.95 | $891.25 | $1,288.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,288.25 | Professional | None | $707.95 | $891.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $446.68 Typical High $794.33 | Professional | None | $70.79 | $446.68 | $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 $616.60 Median $676.08 Typical High $891.25 | Professional | None | $616.60 | $676.08 | $891.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,288.25 | Professional | None | $446.68 | $758.58 | $1,288.25 |
9 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 $346.74 Median $346.74 Typical High $1,174.90 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $467.74 | Professional | 53 · Discontinued | $138.04 | $138.04 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,778.28 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $354.81 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $234.42 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $407.38 Typical High $707.95 | Professional | 62 · Two surgeons | $331.13 | $407.38 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $104.71 Typical High $181.97 | Professional | 80 · Assistant surgeon | $83.18 | $104.71 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $91.20 Typical High $158.49 | Professional | AS · PA/NP assist | $72.44 | $91.20 | $158.49 |
Where Ohio sits
The same service costs 8.5 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
$575
AK $2,951TX $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.