How much rates vary
Facilitymedian $2,570 · 10th to 90th $617 to $8,318Professionalmedian $776 · 10th to 90th $78 to $1,175
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 $794.33 Median $794.33 Typical High $4,786.30 | Professional | None | $794.33 | $794.33 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,230.27 | Professional | None | $630.96 | $758.58 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $2,454.71 Typical High $3,162.28 | Facility | None | $977.24 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,570.40 Typical High $4,168.69 | Facility | None | $489.78 | $2,570.40 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,621.81 | Professional | None | $707.95 | $870.96 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,570.40 Typical High $4,073.80 | Facility | None | $512.86 | $2,570.40 | $4,073.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,621.81 | Professional | None | $707.95 | $870.96 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $741.31 Typical High $1,071.52 | Professional | None | $63.10 | $741.31 | $1,071.52 |
SummaCare Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,412.54 | $1,479.11 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,122.02 | Professional | None | $741.31 | $741.31 | $1,122.02 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,905.46 | Professional | None | $758.58 | $933.25 | $1,905.46 |
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 $398.11 Median $398.11 Typical High $1,318.26 | Professional | 52 · Reduced service | $398.11 | $398.11 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $524.81 | Professional | 53 · Discontinued | $158.49 | $158.49 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $1,995.26 | Professional | 54 · Surgery only | $588.84 | $588.84 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $398.11 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $263.03 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $478.63 Typical High $776.25 | Professional | 62 · Two surgeons | $398.11 | $478.63 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $120.23 Typical High $204.17 | Professional | 80 · Assistant surgeon | $100.00 | $120.23 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $173.78 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $173.78 |
Where Ohio sits
The same service costs 5.8 times more in Alaska 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
$794
AK $3,311UT $575
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.