How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $12,589Professionalmedian $977 · 10th to 90th $83 to $1,413
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 $1,047.13 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,047.13 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,047.13 | $2,454.71 |
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 $831.76 Median $977.24 Typical High $1,412.54 | Professional | None | $831.76 | $977.24 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,122.02 | $1,258.93 |
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 $1,023.29 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,122.02 | $1,737.80 |
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 $1,023.29 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,122.02 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $776.25 Typical High $1,318.26 | Professional | None | $69.18 | $776.25 | $1,318.26 |
SummaCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,023.29 | $1,202.26 |
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 $870.96 Median $1,122.02 Typical High $1,698.24 | Professional | None | $870.96 | $1,122.02 | $1,698.24 |
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 $524.81 Median $524.81 Typical High $691.83 | Professional | 52 · Reduced service | $524.81 | $524.81 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | 53 · Discontinued | $208.93 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $1,047.13 | Professional | 54 · Surgery only | $794.33 | $794.33 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $891.25 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $229.09 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $199.53 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $199.53 |
Where Ohio sits
The same service costs 24.5 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
$977
AK $4,266TX $174
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.