How much rates vary
Facilitymedian $3,715 · 10th to 90th $501 to $19,498Professionalmedian $977 · 10th to 90th $83 to $1,380
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,000.00 | $2,344.23 |
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 $851.14 Median $1,000.00 Typical High $1,445.44 | Professional | None | $851.14 | $1,000.00 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,047.13 | $1,202.26 |
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 $1,000.00 Median $1,071.52 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,071.52 | $1,819.70 |
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 $1,000.00 Median $1,071.52 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,071.52 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $741.31 Typical High $1,258.93 | Professional | None | $69.18 | $741.31 | $1,258.93 |
SummaCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,000.00 | $1,174.90 |
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 $831.76 Median $1,071.52 Typical High $1,659.59 | Professional | None | $831.76 | $1,071.52 | $1,659.59 |
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 $501.19 Median $501.19 Typical High $660.69 | Professional | 52 · Reduced service | $501.19 | $501.19 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | 54 · Surgery only | $741.31 | $741.31 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $630.96 Typical High $912.01 | Professional | 62 · Two surgeons | $537.03 | $630.96 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $162.18 Typical High $234.42 | Professional | 80 · Assistant surgeon | $134.90 | $162.18 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $204.17 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $204.17 |
Where Ohio sits
The same service costs 24.5 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
$977
AK $4,074TX $166
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.