How much rates vary
Facilitymedian $2,570 · 10th to 90th $724 to $10,715Professionalmedian $1,096 · 10th to 90th $174 to $1,660
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 $1,202.26 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 $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,862.09 | Professional | None | $891.25 | $1,202.26 | $1,862.09 |
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 $549.54 Median $2,398.83 Typical High $3,801.89 | Facility | None | $549.54 | $2,398.83 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,548.82 | $2,511.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $3,715.35 | Facility | None | $549.54 | $2,398.83 | $3,715.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,548.82 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $933.25 Typical High $1,445.44 | Professional | None | $162.18 | $933.25 | $1,445.44 |
SummaCare Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,174.90 | $1,230.27 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,096.48 | $1,737.80 |
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 $1,096.48 Median $1,445.44 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,445.44 | $3,019.95 |
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 $588.84 Median $588.84 Typical High $2,137.96 | Professional | 52 · Reduced service | $588.84 | $588.84 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $851.14 | Professional | 53 · Discontinued | $239.88 | $239.88 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $3,162.28 | Professional | 54 · Surgery only | $891.25 | $891.25 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $645.65 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $426.58 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $741.31 Typical High $1,174.90 | Professional | 62 · Two surgeons | $562.34 | $741.31 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $190.55 Typical High $302.00 | Professional | 80 · Assistant surgeon | $144.54 | $190.55 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $165.96 Typical High $263.03 | Professional | AS · PA/NP assist | $125.89 | $165.96 | $263.03 |
Where Ohio sits
The same service costs 7.2 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· 47th of 51
$1,122
AK $4,898TX $676
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.