How much rates vary
Facilitymedian $5,248 · 10th to 90th $955 to $13,183Professionalmedian $1,047 · 10th to 90th $138 to $1,585
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 $3,715.35 Median $10,232.93 Typical High $15,135.61 | Facility | None | $3,715.35 | $10,232.93 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $11,220.18 | Professional | None | $1,096.48 | $1,096.48 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,981.07 Typical High $20,892.96 | Facility | None | $1,047.13 | $3,981.07 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,778.28 | Professional | None | $891.25 | $1,122.02 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $6,165.95 | Facility | None | $1,380.38 | $4,786.30 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,897.79 Typical High $7,762.47 | Facility | None | $758.58 | $4,897.79 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,344.23 | Professional | None | $977.24 | $1,445.44 | $2,344.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $4,897.79 Typical High $7,585.78 | Facility | None | $794.33 | $4,897.79 | $7,585.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,344.23 | Professional | None | $977.24 | $1,445.44 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $870.96 Typical High $1,380.38 | Professional | None | $123.03 | $870.96 | $1,380.38 |
SummaCare Setting Facility Modifier None Typical Low $5,248.07 Median $5,495.41 Typical High $6,309.57 | Facility | None | $5,248.07 | $5,495.41 | $6,309.57 |
SummaCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,023.29 | $1,584.89 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,348.96 | $2,818.38 |
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 $549.54 Median $549.54 Typical High $1,862.09 | Professional | 52 · Reduced service | $549.54 | $549.54 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $741.31 | Professional | 53 · Discontinued | $218.78 | $218.78 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $2,754.23 | Professional | 54 · Surgery only | $812.83 | $812.83 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $549.54 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $371.54 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $707.95 Typical High $1,122.02 | Professional | 62 · Two surgeons | $549.54 | $707.95 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $177.83 Typical High $288.40 | Professional | 80 · Assistant surgeon | $141.25 | $177.83 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $154.88 Typical High $245.47 | Professional | AS · PA/NP assist | $123.03 | $154.88 | $245.47 |
Where Ohio sits
The same service costs 8.7 times more in Oklahoma 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· 48th of 51
$1,072
OK $6,166TX $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.