How much rates vary
Facilitymedian $1,905 · 10th to 90th $724 to $8,913Professionalmedian $692 · 10th to 90th $91 to $1,023
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 $2,398.83 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,398.83 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $9,120.11 | Professional | None | $724.44 | $724.44 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $4,786.30 | Facility | None | $630.96 | $1,230.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,096.48 | Professional | None | $549.54 | $691.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $107.15 Typical High $181.97 | Professional | 80 · Assistant surgeon | $87.10 | $107.15 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $95.50 Typical High $154.88 | Professional | AS · PA/NP assist | $75.86 | $95.50 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,584.89 Typical High $2,089.30 | Facility | None | $870.96 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,819.70 Typical High $3,162.28 | Facility | None | $741.31 | $1,819.70 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,445.44 | Professional | None | $616.60 | $758.58 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,819.70 Typical High $3,090.30 | Facility | None | $741.31 | $1,819.70 | $3,090.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,445.44 | Professional | None | $616.60 | $758.58 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $645.65 Typical High $912.01 | Professional | None | $79.43 | $645.65 | $912.01 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,000.00 | Professional | None | $645.65 | $645.65 | $1,000.00 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,621.81 | Professional | None | $645.65 | $794.33 | $1,621.81 |
6 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 $363.08 Median $363.08 Typical High $1,202.26 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $478.63 | Professional | 53 · Discontinued | $144.54 | $144.54 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $1,819.70 | Professional | 54 · Surgery only | $537.03 | $537.03 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $363.08 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $239.88 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $1,698.24 |
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· 49th of 51
$708
AK $2,818UT $490
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.