How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $12,589Professionalmedian $2,138 · 10th to 90th $219 to $3,236
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 $2,454.71 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,454.71 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $7,762.47 | Professional | None | $2,454.71 | $2,454.71 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,803.84 | Facility | None | $891.25 | $6,606.93 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,137.96 | $3,162.28 |
CareSource Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
CareSource Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,951.21 | Professional | None | $2,570.40 | $2,570.40 | $2,951.21 |
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 $2,344.23 Median $2,630.27 Typical High $4,073.80 | Professional | None | $2,344.23 | $2,630.27 | $4,073.80 |
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 $2,344.23 Median $2,630.27 Typical High $4,073.80 | Professional | None | $2,344.23 | $2,630.27 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,778.28 Typical High $2,951.21 | Professional | None | $194.98 | $1,778.28 | $2,951.21 |
SummaCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,344.23 | $2,754.23 |
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 $1,995.26 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,995.26 | $2,630.27 | $3,981.07 |
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 $1,230.27 Median $1,230.27 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $645.65 | Professional | 53 · Discontinued | $489.78 | $489.78 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $489.78 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,348.96 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,148.15 | $1,348.96 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $346.74 Typical High $512.86 | Professional | 80 · Assistant surgeon | $295.12 | $346.74 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $302.00 Typical High $446.68 | Professional | AS · PA/NP assist | $257.04 | $302.00 | $446.68 |
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· 46th of 51
$2,138
AK $8,318TX $389
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.