How much rates vary
Facilitymedian $1,549 · 10th to 90th $447 to $10,233Professionalmedian $1,072 · 10th to 90th $141 to $1,698
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 $1,122.02 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,122.02 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $5,248.07 | Professional | None | $1,122.02 | $1,122.02 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $7,762.47 | Facility | None | $851.14 | $2,630.27 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,778.28 | Professional | None | $831.76 | $977.24 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
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 $1,071.52 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,380.38 | $2,454.71 |
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 $1,071.52 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,380.38 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $977.24 Typical High $1,548.82 | Professional | None | $125.89 | $977.24 | $1,548.82 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,122.02 | $1,698.24 |
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 $954.99 Median $1,230.27 Typical High $2,570.40 | Professional | None | $954.99 | $1,230.27 | $2,570.40 |
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 $562.34 Median $562.34 Typical High $1,905.46 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $758.58 | Professional | 53 · Discontinued | $223.87 | $223.87 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $2,818.38 | Professional | 54 · Surgery only | $851.14 | $851.14 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $562.34 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $380.19 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $645.65 Typical High $1,122.02 | Professional | 62 · Two surgeons | $524.81 | $645.65 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $288.40 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $251.19 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $251.19 |
Where Ohio sits
The same service costs 6.8 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· 47th of 51
$1,072
AK $4,571TX $676
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.