How much rates vary
Facilitymedian $2,951 · 10th to 90th $708 to $10,233Professionalmedian $1,023 · 10th to 90th $135 to $1,660
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 $1,174.90 Median $1,174.90 Typical High $9,120.11 | Professional | None | $1,174.90 | $1,174.90 | $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 $707.95 Median $870.96 Typical High $1,698.24 | Professional | None | $707.95 | $870.96 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $5,011.87 | Facility | None | $549.54 | $2,884.03 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,202.26 | $2,238.72 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,202.26 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $954.99 Typical High $1,513.56 | Professional | None | $120.23 | $954.99 | $1,513.56 |
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 $1,096.48 Median $1,096.48 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,096.48 | $1,548.82 |
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 $812.83 Median $1,230.27 Typical High $2,691.53 | Professional | None | $812.83 | $1,230.27 | $2,691.53 |
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 $588.84 Median $588.84 Typical High $2,454.71 | Professional | 52 · Reduced service | $588.84 | $588.84 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $977.24 | Professional | 53 · Discontinued | $234.42 | $234.42 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $3,630.78 | Professional | 54 · Surgery only | $891.25 | $891.25 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $724.44 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $489.78 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $562.34 Typical High $1,071.52 | Professional | 62 · Two surgeons | $446.68 | $562.34 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $141.25 Typical High $275.42 | Professional | 80 · Assistant surgeon | $112.20 | $141.25 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $123.03 Typical High $239.88 | Professional | AS · PA/NP assist | $97.72 | $123.03 | $239.88 |
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· 48th of 51
$1,072
AK $4,898TX $759
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.