How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $16,218Professionalmedian $1,288 · 10th to 90th $209 to $2,042
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 $1,380.38 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,380.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $9,120.11 | Professional | None | $1,380.38 | $1,380.38 | $9,120.11 |
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 $1,071.52 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,288.25 | $2,187.76 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,288.25 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,778.28 | $2,818.38 |
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 $1,288.25 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,778.28 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,174.90 Typical High $1,862.09 | Professional | None | $199.53 | $1,174.90 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,348.96 | $2,041.74 |
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 $1,258.93 Median $1,548.82 Typical High $3,548.13 | Professional | None | $1,258.93 | $1,548.82 | $3,548.13 |
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 $691.83 Median $691.83 Typical High $3,019.95 | Professional | 52 · Reduced service | $691.83 | $691.83 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,202.26 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $912.01 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $602.56 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $831.76 Typical High $1,380.38 | Professional | 62 · Two surgeons | $676.08 | $831.76 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $208.93 Typical High $363.08 | Professional | 80 · Assistant surgeon | $169.82 | $208.93 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $309.03 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $309.03 |
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· 44th of 51
$1,349
AK $5,754TX $813
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.