How much rates vary
Facilitymedian $3,090 · 10th to 90th $851 to $10,715Professionalmedian $724 · 10th to 90th $91 to $1,023
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 $2,570.40 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,570.40 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $2,691.53 | Professional | None | $724.44 | $724.44 | $2,691.53 |
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 $645.65 Median $758.58 Typical High $1,071.52 | Professional | None | $645.65 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $173.78 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $151.36 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $3,630.78 | Facility | None | $891.25 | $2,818.38 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | None | $758.58 | $758.58 | $870.96 |
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 $691.83 Median $724.44 Typical High $1,348.96 | Professional | None | $691.83 | $724.44 | $1,348.96 |
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 $691.83 Median $724.44 Typical High $1,318.26 | Professional | None | $691.83 | $724.44 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $588.84 Typical High $933.25 | Professional | None | $64.57 | $588.84 | $933.25 |
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 $691.83 Median $691.83 Typical High $812.83 | Professional | None | $691.83 | $691.83 | $812.83 |
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 $588.84 Median $741.31 Typical High $1,148.15 | Professional | None | $588.84 | $741.31 | $1,148.15 |
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 $363.08 Median $363.08 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $363.08 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | 54 · Surgery only | $537.03 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $660.69 |
Where Ohio sits
The same service costs 6.2 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· 44th of 51
$724
AK $3,020TX $490
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.