How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $1,202 · 10th to 90th $120 to $1,738
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 $1,318.26 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,318.26 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,318.26 | $2,630.27 |
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 $1,023.29 Median $1,202.26 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,202.26 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,380.38 | $1,548.82 |
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 $1,288.25 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,380.38 | $2,290.87 |
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 $1,318.26 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,380.38 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $977.24 Typical High $1,621.81 | Professional | None | $102.33 | $977.24 | $1,621.81 |
SummaCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,318.26 | $1,513.56 |
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 $1,071.52 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,380.38 | $2,137.96 |
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 $645.65 Median $645.65 Typical High $870.96 | Professional | 52 · Reduced service | $645.65 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | 53 · Discontinued | $263.03 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $257.04 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,096.48 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $281.84 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $245.47 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $245.47 |
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· 47th of 51
$1,202
AK $4,571TX $214
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.