How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $2,630 · 10th to 90th $257 to $3,802
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 $2,884.03 Median $10,715.19 Typical High $13,803.84 | Facility | None | $2,884.03 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $4,677.35 | Professional | None | $2,884.03 | $2,884.03 | $4,677.35 |
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 $2,344.23 Median $2,754.23 Typical High $3,890.45 | Professional | None | $2,344.23 | $2,754.23 | $3,890.45 |
CareSource Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,467.37 | Professional | None | $3,019.95 | $3,019.95 | $3,467.37 |
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 $2,754.23 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,754.23 | $2,884.03 | $4,897.79 |
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 $2,754.23 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,754.23 | $2,884.03 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $2,089.30 Typical High $3,548.13 | Professional | None | $229.09 | $2,089.30 | $3,548.13 |
SummaCare Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,754.23 | $2,754.23 | $3,235.94 |
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 $2,290.87 Median $2,884.03 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,884.03 | $4,466.84 |
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 $1,445.44 Median $1,445.44 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | 53 · Discontinued | $575.44 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,187.76 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,187.76 | $2,187.76 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $436.52 Typical High $562.34 | Professional | 55 · Aftercare only | $436.52 | $436.52 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $1,737.80 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,479.11 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $436.52 Typical High $645.65 | Professional | 80 · Assistant surgeon | $371.54 | $436.52 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $389.05 Typical High $562.34 | Professional | AS · PA/NP assist | $323.59 | $389.05 | $562.34 |
Where Ohio sits
The same service costs 21.4 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
$2,630
AK $9,772TX $457
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.