How much rates vary
Facilitymedian $3,090 · 10th to 90th $851 to $10,715Professionalmedian $955 · 10th to 90th $135 to $1,413
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 $2,630.27 Median $9,120.11 Typical High $12,589.25 | Facility | None | $2,630.27 | $9,120.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $4,073.80 | Professional | None | $954.99 | $954.99 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $7,079.46 | Facility | None | $724.44 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,412.54 | Professional | None | $831.76 | $977.24 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $229.09 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $194.98 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,202.26 | $2,818.38 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | None | $1,000.00 | $1,000.00 | $1,148.15 |
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 $912.01 Median $1,000.00 Typical High $1,698.24 | Professional | None | $912.01 | $1,000.00 | $1,698.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $4,570.88 | Facility | None | $794.33 | $3,162.28 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,659.59 | Professional | None | $933.25 | $1,000.00 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $831.76 Typical High $1,348.96 | Professional | None | $95.50 | $831.76 | $1,348.96 |
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 $954.99 Median $954.99 Typical High $1,122.02 | Professional | None | $954.99 | $954.99 | $1,122.02 |
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 $776.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $776.25 | $1,023.29 | $1,548.82 |
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 $478.63 Median $478.63 Typical High $616.60 | Professional | 52 · Reduced service | $478.63 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $933.25 | Professional | 54 · Surgery only | $707.95 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $870.96 |
Where Ohio sits
The same service costs 5.8 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· 44th of 51
$955
AK $3,981TX $692
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.