How much rates vary
Facilitymedian $4,571 · 10th to 90th $617 to $12,023Professionalmedian $813 · 10th to 90th $78 to $1,230
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 $812.83 Median $812.83 Typical High $9,120.11 | Professional | None | $812.83 | $812.83 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,489.63 | Facility | None | $891.25 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,318.26 | Professional | None | $645.65 | $812.83 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,548.82 | Facility | None | $794.33 | $1,023.29 | $1,548.82 |
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 $724.44 Median $891.25 Typical High $1,659.59 | Professional | None | $724.44 | $891.25 | $1,659.59 |
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 $724.44 Median $891.25 Typical High $1,659.59 | Professional | None | $724.44 | $891.25 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $758.58 Typical High $1,096.48 | Professional | None | $63.10 | $758.58 | $1,096.48 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,174.90 | Professional | None | $758.58 | $758.58 | $1,174.90 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,819.70 Typical High $7,244.36 | Facility | None | $707.95 | $1,819.70 | $7,244.36 |
United Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,995.26 | Professional | None | $776.25 | $954.99 | $1,995.26 |
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 $407.38 Median $407.38 Typical High $1,548.82 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $630.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $2,344.23 | Professional | 54 · Surgery only | $616.60 | $616.60 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $467.74 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $309.03 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $512.86 Typical High $812.83 | Professional | 62 · Two surgeons | $407.38 | $512.86 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $131.83 Typical High $218.78 | Professional | 80 · Assistant surgeon | $102.33 | $131.83 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $112.20 Typical High $186.21 | Professional | AS · PA/NP assist | $91.20 | $112.20 | $186.21 |
Where Ohio sits
The same service costs 6.2 times more in Oklahoma than in Utah. 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
$832
OK $3,631UT $589
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.