How much rates vary
Facilitymedian $5,248 · 10th to 90th $513 to $16,218Professionalmedian $1,148 · 10th to 90th $174 to $1,778
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 $1,202.26 Median $1,202.26 Typical High $10,232.93 | Professional | None | $1,202.26 | $1,202.26 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $8,317.64 Typical High $19,498.45 | Facility | None | $1,122.02 | $8,317.64 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,202.26 | $2,089.30 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,096.48 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,621.81 | $2,570.40 |
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 $1,096.48 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,621.81 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $954.99 Typical High $1,513.56 | Professional | None | $162.18 | $954.99 | $1,513.56 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,122.02 | $1,737.80 |
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 $1,122.02 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,479.11 | $3,090.30 |
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 $602.56 Median $602.56 Typical High $2,041.74 | Professional | 52 · Reduced service | $602.56 | $602.56 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $812.83 | Professional | 53 · Discontinued | $239.88 | $239.88 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $3,019.95 | Professional | 54 · Surgery only | $912.01 | $912.01 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $602.56 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $407.38 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $776.25 Typical High $1,479.11 | Professional | 62 · Two surgeons | $645.65 | $776.25 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $199.53 Typical High $331.13 | Professional | 80 · Assistant surgeon | $165.96 | $199.53 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $173.78 Typical High $288.40 | Professional | AS · PA/NP assist | $144.54 | $173.78 | $288.40 |
Where Ohio sits
The same service costs 7.1 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· 45th of 51
$1,202
AK $5,012TX $708
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.