How much rates vary
Facilitymedian $3,311 · 10th to 90th $490 to $11,749Professionalmedian $794 · 10th to 90th $93 to $1,202
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $9,120.11 | Professional | None | $812.83 | $812.83 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,165.95 Typical High $12,882.50 | Facility | None | $891.25 | $6,165.95 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,412.54 | Professional | None | $676.08 | $870.96 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $831.76 Median $977.24 Typical High $1,737.80 | Professional | None | $831.76 | $977.24 | $1,737.80 |
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 $831.76 Median $954.99 Typical High $1,737.80 | Professional | None | $831.76 | $954.99 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $707.95 Typical High $1,096.48 | Professional | None | $81.28 | $707.95 | $1,096.48 |
SummaCare Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,230.27 | Professional | None | $812.83 | $812.83 | $1,230.27 |
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 $724.44 Median $912.01 Typical High $1,862.09 | Professional | None | $724.44 | $912.01 | $1,862.09 |
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 $407.38 Median $407.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $549.54 | Professional | 53 · Discontinued | $162.18 | $162.18 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $2,041.74 | Professional | 54 · Surgery only | $602.56 | $602.56 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $416.87 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $275.42 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $549.54 Typical High $891.25 | Professional | 62 · Two surgeons | $426.58 | $549.54 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $141.25 Typical High $239.88 | Professional | 80 · Assistant surgeon | $109.65 | $141.25 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $123.03 Typical High $194.98 | Professional | AS · PA/NP assist | $95.50 | $123.03 | $194.98 |
Where Ohio sits
The same service costs 6.2 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
$813
AK $3,311TX $537
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.