How much rates vary
Facilitymedian $4,169 · 10th to 90th $501 to $19,498Professionalmedian $3,467 · 10th to 90th $389 to $5,754
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 $4,466.84 Median $10,715.19 Typical High $13,803.84 | Facility | None | $4,466.84 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $9,332.54 | Professional | None | $4,466.84 | $4,466.84 | $9,332.54 |
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 $4,786.30 | Professional | None | $1,737.80 | $2,041.74 | $4,786.30 |
CareSource Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
CareSource Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,248.07 | Professional | None | $4,677.35 | $4,677.35 | $5,248.07 |
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 $4,073.80 Median $4,786.30 Typical High $7,413.10 | Professional | None | $4,073.80 | $4,786.30 | $7,413.10 |
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 $4,073.80 Median $4,786.30 Typical High $7,244.36 | Professional | None | $4,073.80 | $4,786.30 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $3,235.94 Typical High $5,495.41 | Professional | None | $354.81 | $3,235.94 | $5,495.41 |
SummaCare Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,011.87 | Professional | None | $4,365.16 | $4,365.16 | $5,011.87 |
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 $3,235.94 Median $4,786.30 Typical High $7,413.10 | Professional | None | $3,235.94 | $4,786.30 | $7,413.10 |
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 $2,238.72 Median $2,238.72 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,238.72 | $2,238.72 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $891.25 Typical High $1,174.90 | Professional | 53 · Discontinued | $891.25 | $891.25 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $4,466.84 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | 56 · Pre-op care only | $446.68 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,090.30 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,090.30 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,288.25 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,096.48 | $1,288.25 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $794.33 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $676.08 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $676.08 |
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
$3,467
AK $15,136TX $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.