How much rates vary
Facilitymedian $1,660 · 10th to 90th $589 to $7,244Professionalmedian $1,000 · 10th to 90th $138 to $1,479
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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $3,630.78 | Professional | None | $1,096.48 | $1,096.48 | $3,630.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,318.26 Typical High $4,466.84 | Facility | None | $537.03 | $1,318.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,380.38 | Professional | None | $776.25 | $912.01 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $575.44 Typical High $870.96 | Professional | 62 · Two surgeons | $489.78 | $575.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $223.87 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $194.98 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,737.80 | Facility | None | $1,348.96 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,148.15 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,479.11 Typical High $2,290.87 | Facility | None | $489.78 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,148.15 | $1,778.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $2,187.76 | Facility | None | $512.86 | $1,513.56 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,148.15 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $891.25 Typical High $1,412.54 | Professional | None | $97.72 | $891.25 | $1,412.54 |
SummaCare Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $870.96 | Facility | None | $741.31 | $776.25 | $870.96 |
SummaCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,071.52 | $1,258.93 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,737.80 | Professional | None | $870.96 | $1,148.15 | $1,737.80 |
6 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 $537.03 Median $537.03 Typical High $707.95 | Professional | 52 · Reduced service | $537.03 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $977.24 |
Where Ohio sits
The same service costs 5.2 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
$1,000
AK $3,981TX $759
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.