How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $1,738 · 10th to 90th $234 to $2,818
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 $2,041.74 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,041.74 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $9,772.37 | Professional | None | $2,041.74 | $2,041.74 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $9,332.54 Typical High $21,877.62 | Facility | None | $1,047.13 | $9,332.54 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,737.80 | $2,951.21 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $4,265.80 | Professional | None | $1,778.28 | $2,137.96 | $4,265.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $4,265.80 | Professional | None | $1,778.28 | $2,137.96 | $4,265.80 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $1,548.82 Typical High $2,570.40 | Professional | None | $204.17 | $1,548.82 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,862.09 | $1,862.09 | $2,884.03 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $4,677.35 | Professional | None | $1,698.24 | $2,238.72 | $4,677.35 |
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 $1,023.29 Median $1,023.29 Typical High $4,265.80 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $1,698.24 | Professional | 53 · Discontinued | $407.38 | $407.38 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $6,456.54 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $6,456.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $1,288.25 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $851.14 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,096.48 Typical High $1,862.09 | Professional | 62 · Two surgeons | $870.96 | $1,096.48 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $275.42 Typical High $478.63 | Professional | 80 · Assistant surgeon | $223.87 | $275.42 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $239.88 Typical High $416.87 | Professional | AS · PA/NP assist | $194.98 | $239.88 | $416.87 |
Where Ohio sits
The same service costs 22.9 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
$1,778
AK $8,511TX $372
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.