How much rates vary
Facilitymedian $4,677 · 10th to 90th $617 to $12,589Professionalmedian $1,148 · 10th to 90th $120 to $1,698
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 $1,288.25 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,288.25 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,288.25 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,760.83 Typical High $14,125.38 | Facility | None | $891.25 | $6,760.83 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,737.80 | Professional | None | $977.24 | $1,148.15 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,348.96 | $1,348.96 | $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 $1,230.27 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,380.38 | $2,137.96 |
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 $1,230.27 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,380.38 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $933.25 Typical High $1,584.89 | Professional | None | $102.33 | $933.25 | $1,584.89 |
SummaCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $8,317.64 | Facility | None | $851.14 | $2,754.23 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,348.96 | $2,089.30 |
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 $831.76 | Professional | 52 · Reduced service | $645.65 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $338.84 | Professional | 53 · Discontinued | $257.04 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,258.93 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $1,096.48 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $281.84 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $245.47 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $245.47 |
Where Ohio sits
The same service costs 26.3 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· 46th of 51
$1,148
AK $5,248TX $200
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.