How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $933 · 10th to 90th $141 to $1,514
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $9,120.11 | Professional | None | $912.01 | $912.01 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $12,022.64 Typical High $28,183.83 | Facility | None | $1,479.11 | $12,022.64 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,513.56 | Professional | None | $691.83 | $812.83 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,000.00 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,288.25 | $2,089.30 |
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 $1,000.00 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,288.25 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $891.25 Typical High $1,412.54 | Professional | None | $123.03 | $891.25 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,047.13 | $1,548.82 |
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 $933.25 Median $1,258.93 Typical High $2,511.89 | Professional | None | $933.25 | $1,258.93 | $2,511.89 |
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 $457.09 Median $457.09 Typical High $2,511.89 | Professional | 52 · Reduced service | $457.09 | $457.09 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $1,000.00 | Professional | 53 · Discontinued | $181.97 | $181.97 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $3,715.35 | Professional | 54 · Surgery only | $691.83 | $691.83 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $741.31 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $501.19 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $512.86 Typical High $954.99 | Professional | 62 · Two surgeons | $436.52 | $512.86 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $257.04 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $114.82 Typical High $218.78 | Professional | AS · PA/NP assist | $97.72 | $114.82 | $218.78 |
Where Ohio sits
The same service costs 18.6 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
$977
AK $4,169TX $224
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.