How much rates vary
Facilitymedian $2,884 · 10th to 90th $692 to $9,333Professionalmedian $1,318 · 10th to 90th $170 to $1,995
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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $9,120.11 | Professional | None | $1,380.38 | $1,380.38 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,412.54 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,698.24 | Facility | None | $794.33 | $1,174.90 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $4,897.79 | Facility | None | $549.54 | $2,884.03 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,445.44 | $2,884.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $562.34 Median $2,884.03 Typical High $4,897.79 | Facility | None | $562.34 | $2,884.03 | $4,897.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,412.54 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,122.02 Typical High $1,737.80 | Professional | None | $158.49 | $1,122.02 | $1,737.80 |
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 $1,288.25 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,288.25 | $2,089.30 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $3,162.28 | Professional | None | $1,258.93 | $1,548.82 | $3,162.28 |
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 $691.83 Median $691.83 Typical High $2,454.71 | Professional | 52 · Reduced service | $691.83 | $691.83 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,000.00 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $741.31 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $489.78 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $371.54 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $323.59 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $323.59 |
Where Ohio sits
The same service costs 6.5 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· 47th of 51
$1,349
AK $5,754TX $891
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.