How much rates vary
Facilitymedian $4,677 · 10th to 90th $513 to $16,596Professionalmedian $1,047 · 10th to 90th $138 to $1,585
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 $10,000.00 Typical High $13,803.84 | Facility | None | $3,890.45 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $10,964.78 | Professional | None | $1,071.52 | $1,071.52 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $19,952.62 | Facility | None | $1,047.13 | $7,943.28 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,698.24 | Professional | None | $870.96 | $1,023.29 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $645.65 Typical High $1,071.52 | Professional | 62 · Two surgeons | $549.54 | $645.65 | $1,071.52 |
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 |
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 $954.99 Median $1,174.90 Typical High $2,187.76 | Professional | None | $954.99 | $1,174.90 | $2,187.76 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,187.76 | Professional | None | $954.99 | $1,174.90 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,000.00 Typical High $1,412.54 | Professional | None | $123.03 | $1,000.00 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,000.00 | $1,513.56 |
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 $1,023.29 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,258.93 | $2,570.40 |
8 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 $2,187.76 | Professional | 52 · Reduced service | $537.03 | $537.03 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $891.25 | Professional | 53 · Discontinued | $213.80 | $213.80 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $3,311.31 | Professional | 54 · Surgery only | $812.83 | $812.83 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $660.69 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $436.52 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $269.15 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $234.42 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $234.42 |
Where Ohio sits
The same service costs 5.9 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· 48th of 51
$1,072
AK $4,365TX $741
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.