How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $10,965Professionalmedian $3,467 · 10th to 90th $355 to $5,129
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 $3,890.45 Median $10,715.19 Typical High $13,803.84 | Facility | None | $3,890.45 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $9,120.11 | Professional | None | $3,890.45 | $3,890.45 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,623.41 Typical High $10,964.78 | Facility | None | $891.25 | $5,623.41 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $3,630.78 Typical High $5,128.61 | Professional | None | $3,019.95 | $3,630.78 | $5,128.61 |
CareSource Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
CareSource Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,677.35 | Professional | None | $4,073.80 | $4,073.80 | $4,677.35 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $4,168.69 Typical High $6,456.54 | Professional | None | $3,715.35 | $4,168.69 | $6,456.54 |
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 $3,715.35 Median $4,168.69 Typical High $6,456.54 | Professional | None | $3,715.35 | $4,168.69 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $2,818.38 Typical High $4,677.35 | Professional | None | $323.59 | $2,818.38 | $4,677.35 |
SummaCare Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,365.16 | Professional | None | $3,715.35 | $3,715.35 | $4,365.16 |
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 $3,162.28 Median $4,073.80 Typical High $6,309.57 | Professional | None | $3,162.28 | $4,073.80 | $6,309.57 |
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 $1,949.84 Median $1,949.84 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $1,023.29 | Professional | 53 · Discontinued | $776.25 | $776.25 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $3,801.89 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $512.86 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,905.46 Median $2,290.87 Typical High $3,235.94 | Professional | 62 · Two surgeons | $1,905.46 | $2,290.87 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $575.44 Typical High $812.83 | Professional | 80 · Assistant surgeon | $489.78 | $575.44 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $501.19 Typical High $707.95 | Professional | AS · PA/NP assist | $426.58 | $501.19 | $707.95 |
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· 45th of 51
$3,467
AK $13,183TX $603
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.