How much rates vary
Facilitymedian $1,862 · 10th to 90th $447 to $12,589Professionalmedian $2,630 · 10th to 90th $398 to $4,266
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 $3,019.95 Median $10,715.19 Typical High $13,803.84 | Facility | None | $3,019.95 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $10,964.78 | Professional | None | $3,019.95 | $3,019.95 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $3,890.45 | Professional | None | $1,412.54 | $1,819.70 | $3,890.45 |
CareSource Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $2,691.53 Median $3,715.35 Typical High $6,025.60 | Professional | None | $2,691.53 | $3,715.35 | $6,025.60 |
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 $2,754.23 Median $3,715.35 Typical High $6,025.60 | Professional | None | $2,754.23 | $3,715.35 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $371.54 Median $2,454.71 Typical High $3,890.45 | Professional | None | $371.54 | $2,454.71 | $3,890.45 |
SummaCare Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,951.21 | $2,951.21 | $4,365.16 |
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 $2,511.89 Median $3,311.31 Typical High $6,918.31 | Professional | None | $2,511.89 | $3,311.31 | $6,918.31 |
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 $1,513.56 Median $1,513.56 Typical High $5,248.07 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $5,248.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $2,089.30 | Professional | 53 · Discontinued | $602.56 | $602.56 | $2,089.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $7,762.47 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $1,548.82 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $1,047.13 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $1,047.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $7,244.36 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,148.15 Typical High $2,454.71 | Professional | 62 · Two surgeons | $891.25 | $1,148.15 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $295.12 Typical High $660.69 | Professional | 80 · Assistant surgeon | $229.09 | $295.12 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $257.04 Typical High $562.34 | Professional | AS · PA/NP assist | $199.53 | $257.04 | $562.34 |
Where Ohio sits
The same service costs 12.6 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
$2,570
AK $12,023TX $955
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.