How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $2,399 · 10th to 90th $240 to $3,467
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 $2,691.53 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,691.53 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $5,495.41 | Professional | None | $2,691.53 | $2,691.53 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $9,332.54 Typical High $21,877.62 | Facility | None | $1,047.13 | $9,332.54 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,511.89 | $3,630.78 |
CareSource Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
CareSource Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,818.38 | $2,818.38 | $3,162.28 |
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 $2,454.71 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,454.71 | $2,818.38 | $4,897.79 |
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 $2,511.89 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,511.89 | $2,818.38 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $1,819.70 Typical High $3,162.28 | Professional | None | $204.17 | $1,819.70 | $3,162.28 |
SummaCare Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,454.71 | $2,884.03 |
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 $2,187.76 Median $2,818.38 Typical High $4,365.16 | Professional | None | $2,187.76 | $2,818.38 | $4,365.16 |
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 $1,348.96 Median $1,348.96 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | 53 · Discontinued | $537.03 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $524.81 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,584.89 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,348.96 | $1,584.89 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $588.84 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $354.81 Typical High $512.86 | Professional | AS · PA/NP assist | $295.12 | $354.81 | $512.86 |
Where Ohio sits
The same service costs 22.9 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
$2,399
AK $9,120TX $398
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.