How much rates vary
Facilitymedian $3,090 · 10th to 90th $851 to $10,715Professionalmedian $1,413 · 10th to 90th $191 to $2,344
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 $1,479.11 Median $9,772.37 Typical High $12,882.50 | Facility | None | $1,479.11 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $9,120.11 | Professional | None | $1,148.15 | $1,479.11 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $7,762.47 | Facility | None | $794.33 | $2,238.72 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,089.30 | Professional | None | $954.99 | $1,318.26 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $208.93 Typical High $338.84 | Professional | 80 · Assistant surgeon | $154.88 | $208.93 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $181.97 Typical High $295.12 | Professional | AS · PA/NP assist | $134.90 | $181.97 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,445.44 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $4,897.79 | Facility | None | $794.33 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,513.56 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $3,162.28 Typical High $4,570.88 | Facility | None | $851.14 | $3,162.28 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,513.56 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,479.11 Typical High $2,290.87 | Professional | None | $158.49 | $1,479.11 | $2,290.87 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,621.81 | $2,089.30 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,548.82 | $3,090.30 |
6 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 $575.44 Median $741.31 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $741.31 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $295.12 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $1,096.48 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $218.78 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $147.91 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,023.29 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $1,023.29 | $1,071.52 |
Where Ohio sits
The same service costs 5.2 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
$1,445
AK $6,026TX $1,148
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.