How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $12,589Professionalmedian $1,175 · 10th to 90th $174 to $1,820
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 $1,202.26 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,202.26 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $9,120.11 | Professional | None | $1,202.26 | $1,202.26 | $9,120.11 |
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 $1,000.00 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,230.27 | $2,041.74 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,148.15 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,479.11 | $2,630.27 |
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 $1,148.15 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,479.11 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,023.29 Typical High $1,621.81 | Professional | None | $158.49 | $1,023.29 | $1,621.81 |
SummaCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,202.26 | $1,819.70 |
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 $1,071.52 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,380.38 | $2,818.38 |
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 $602.56 Median $602.56 Typical High $2,570.40 | Professional | 52 · Reduced service | $602.56 | $602.56 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $1,023.29 | Professional | 53 · Discontinued | $245.47 | $245.47 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $3,801.89 | Professional | 54 · Surgery only | $912.01 | $912.01 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $758.58 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $512.86 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $776.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $630.96 | $776.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $338.84 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $281.84 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $281.84 |
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· 45th of 51
$1,175
AK $4,898TX $724
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.