How much rates vary
Facilitymedian $3,090 · 10th to 90th $851 to $10,715Professionalmedian $1,148 · 10th to 90th $141 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 $1,258.93 Median $1,258.93 Typical High $10,232.93 | Professional | None | $1,258.93 | $1,258.93 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $7,762.47 | Facility | None | $794.33 | $2,238.72 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,862.09 | Professional | None | $933.25 | $1,148.15 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,548.82 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $4,897.79 | Facility | None | $794.33 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,288.25 | $2,511.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $3,162.28 Typical High $4,570.88 | Facility | None | $851.14 | $3,162.28 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,288.25 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,023.29 Typical High $1,621.81 | Professional | None | $123.03 | $1,023.29 | $1,621.81 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,174.90 | $1,737.80 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,318.26 | $2,884.03 |
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 $630.96 Median $630.96 Typical High $1,995.26 | Professional | 52 · Reduced service | $630.96 | $630.96 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $812.83 | Professional | 53 · Discontinued | $251.19 | $251.19 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $3,019.95 | Professional | 54 · Surgery only | $933.25 | $933.25 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $602.56 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $398.11 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $724.44 Typical High $1,174.90 | Professional | 62 · Two surgeons | $588.84 | $724.44 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $186.21 Typical High $323.59 | Professional | 80 · Assistant surgeon | $147.91 | $186.21 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $162.18 Typical High $263.03 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $263.03 |
Where Ohio sits
The same service costs 6.6 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
$1,175
AK $5,248TX $794
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.