How much rates vary
Facilitymedian $6,166 · 10th to 90th $513 to $23,442Professionalmedian $2,344 · 10th to 90th $347 to $3,890
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 $8,912.51 Typical High $13,803.84 | Facility | None | $3,715.35 | $8,912.51 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $13,489.63 | Professional | None | $2,344.23 | $2,344.23 | $13,489.63 |
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 $1,995.26 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,995.26 | $2,344.23 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $2,398.83 Median $3,388.44 Typical High $5,495.41 | Professional | None | $2,398.83 | $3,388.44 | $5,495.41 |
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 $2,398.83 Median $3,388.44 Typical High $5,495.41 | Professional | None | $2,398.83 | $3,388.44 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $2,187.76 Typical High $3,467.37 | Professional | None | $316.23 | $2,187.76 | $3,467.37 |
SummaCare Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,801.89 | Professional | None | $2,570.40 | $2,570.40 | $3,801.89 |
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 $2,454.71 Median $3,388.44 Typical High $6,309.57 | Professional | None | $2,454.71 | $3,388.44 | $6,309.57 |
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 $1,174.90 Median $1,174.90 Typical High $6,760.83 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $6,760.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $2,691.53 | Professional | 53 · Discontinued | $467.74 | $467.74 | $2,691.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $10,000.00 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $10,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $1,995.26 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $1,995.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $1,348.96 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $1,348.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $9,332.54 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $380.19 Typical High $645.65 | Professional | 80 · Assistant surgeon | $323.59 | $380.19 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $331.13 Typical High $562.34 | Professional | AS · PA/NP assist | $281.84 | $331.13 | $562.34 |
Where Ohio sits
The same service costs 17.0 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
$2,399
AK $10,471TX $617
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.