How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $1,318 · 10th to 90th $138 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 $1,412.54 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,412.54 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $9,332.54 | Professional | None | $1,412.54 | $1,412.54 | $9,332.54 |
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 $1,174.90 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,445.44 | $2,398.83 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,258.93 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,479.11 | $2,884.03 |
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 $1,258.93 Median $1,445.44 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,445.44 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,096.48 Typical High $1,698.24 | Professional | None | $123.03 | $1,096.48 | $1,698.24 |
SummaCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,258.93 | $2,041.74 |
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 $1,230.27 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,584.89 | $3,235.94 |
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 $707.95 Median $707.95 Typical High $2,884.03 | Professional | 52 · Reduced service | $707.95 | $707.95 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $1,148.15 | Professional | 53 · Discontinued | $281.84 | $281.84 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $851.14 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $575.44 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $912.01 Typical High $1,445.44 | Professional | 62 · Two surgeons | $741.31 | $912.01 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $229.09 Typical High $380.19 | Professional | 80 · Assistant surgeon | $186.21 | $229.09 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $331.13 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $331.13 |
Where Ohio sits
The same service costs 7.8 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· 45th of 51
$1,349
AK $5,754TX $741
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.