How much rates vary
Facilitymedian $2,818 · 10th to 90th $617 to $9,120Professionalmedian $1,549 · 10th to 90th $209 to $2,455
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 $1,949.84 Median $4,570.88 Typical High $12,589.25 | Facility | None | $1,949.84 | $4,570.88 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $7,413.10 | Professional | None | $1,659.59 | $1,659.59 | $7,413.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,548.82 | $2,511.89 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $3,630.78 | Facility | None | $2,041.74 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,818.38 Typical High $4,570.88 | Facility | None | $489.78 | $2,818.38 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,737.80 | $3,467.37 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,884.03 Typical High $4,466.84 | Facility | None | $512.86 | $2,884.03 | $4,466.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,737.80 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,380.38 Typical High $2,187.76 | Professional | None | $194.98 | $1,380.38 | $2,187.76 |
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 $1,584.89 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,584.89 | $2,398.83 |
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 $1,412.54 Median $1,862.09 Typical High $3,801.89 | Professional | None | $1,412.54 | $1,862.09 | $3,801.89 |
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 $831.76 Median $831.76 Typical High $3,311.31 | Professional | 52 · Reduced service | $831.76 | $831.76 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $1,318.26 | Professional | 53 · Discontinued | $331.13 | $331.13 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $5,011.87 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $1,000.00 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $660.69 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $977.24 Typical High $1,584.89 | Professional | 62 · Two surgeons | $831.76 | $977.24 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $426.58 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $354.81 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $354.81 |
Where Ohio sits
The same service costs 7.1 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· 46th of 51
$1,585
AK $7,079TX $1,000
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.