How much rates vary
Facilitymedian $3,467 · 10th to 90th $813 to $12,303Professionalmedian $1,202 · 10th to 90th $174 to $1,820
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $10,232.93 | Professional | None | $1,288.25 | $1,288.25 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,000.00 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,995.26 | Professional | None | $977.24 | $1,258.93 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,090.30 Typical High $5,248.07 | Facility | None | $549.54 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,148.15 | $1,698.24 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,090.30 Typical High $5,128.61 | Facility | None | $549.54 | $3,090.30 | $5,128.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,148.15 | $1,698.24 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,023.29 Typical High $1,584.89 | Professional | None | $162.18 | $1,023.29 | $1,584.89 |
SummaCare Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,995.26 | Facility | None | $1,659.59 | $1,737.80 | $1,995.26 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,174.90 | $1,862.09 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,174.90 | $1,584.89 | $3,235.94 |
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 $645.65 Median $645.65 Typical High $2,290.87 | Professional | 52 · Reduced service | $645.65 | $645.65 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $912.01 | Professional | 53 · Discontinued | $257.04 | $257.04 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $3,467.37 | Professional | 54 · Surgery only | $954.99 | $954.99 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $691.83 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $457.09 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $794.33 Typical High $1,258.93 | Professional | 62 · Two surgeons | $616.60 | $794.33 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $204.17 Typical High $331.13 | Professional | 80 · Assistant surgeon | $158.49 | $204.17 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $177.83 Typical High $288.40 | Professional | AS · PA/NP assist | $134.90 | $177.83 | $288.40 |
Where Ohio sits
The same service costs 6.9 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· 46th of 51
$1,230
AK $5,370TX $776
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.