How much rates vary
Facilitymedian $5,012 · 10th to 90th $955 to $13,183Professionalmedian $1,148 · 10th to 90th $120 to $1,660
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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $4,265.80 | Professional | None | $1,258.93 | $1,258.93 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,202.26 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
CareSource 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 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,897.79 Typical High $8,317.64 | Facility | None | $549.54 | $4,897.79 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,348.96 | $2,137.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,897.79 Typical High $7,762.47 | Facility | None | $549.54 | $4,897.79 | $7,762.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,348.96 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $891.25 Typical High $1,513.56 | Professional | None | $102.33 | $891.25 | $1,513.56 |
SummaCare Setting Facility Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $3,162.28 | Facility | None | $2,630.27 | $2,754.23 | $3,162.28 |
SummaCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,202.26 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,318.26 | $2,041.74 |
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 $630.96 Median $630.96 Typical High $831.76 | Professional | 52 · Reduced service | $630.96 | $630.96 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,071.52 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $275.42 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $239.88 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $239.88 |
Where Ohio sits
The same service costs 25.7 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· 44th of 51
$1,175
AK $5,129TX $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.