How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $2,818 · 10th to 90th $339 to $4,677
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 $3,548.13 Median $10,715.19 Typical High $13,803.84 | Facility | None | $3,548.13 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $5,754.40 | Professional | None | $3,548.13 | $3,548.13 | $5,754.40 |
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 $1,737.80 Median $2,041.74 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,041.74 | $4,073.80 |
CareSource Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
CareSource Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,265.80 | Professional | None | $3,801.89 | $3,801.89 | $4,265.80 |
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 $3,311.31 Median $3,890.45 Typical High $5,888.44 | Professional | None | $3,311.31 | $3,890.45 | $5,888.44 |
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 $3,388.44 Median $3,890.45 Typical High $5,888.44 | Professional | None | $3,388.44 | $3,890.45 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $2,570.40 Typical High $4,365.16 | Professional | None | $302.00 | $2,570.40 | $4,365.16 |
SummaCare Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,073.80 | Professional | None | $3,467.37 | $3,467.37 | $4,073.80 |
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 $2,630.27 Median $3,801.89 Typical High $5,888.44 | Professional | None | $2,630.27 | $3,801.89 | $5,888.44 |
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 $1,778.28 Median $1,778.28 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | 53 · Discontinued | $707.95 | $707.95 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $478.63 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,288.25 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,096.48 | $1,288.25 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $660.69 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $281.84 Typical High $575.44 | Professional | AS · PA/NP assist | $239.88 | $281.84 | $575.44 |
Where Ohio sits
The same service costs 21.9 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· 49th of 51
$2,818
AK $12,303TX $562
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.