How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $1,995 · 10th to 90th $275 to $3,236
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 $1,949.84 Median $10,471.29 Typical High $13,803.84 | Facility | None | $1,949.84 | $10,471.29 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $10,471.29 | Professional | None | $1,949.84 | $1,949.84 | $10,471.29 |
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 $1,621.81 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,621.81 | $1,949.84 | $3,388.44 |
CareSource Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $2,041.74 Median $2,818.38 Typical High $4,570.88 | Professional | None | $2,041.74 | $2,818.38 | $4,570.88 |
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 $2,041.74 Median $2,818.38 Typical High $4,570.88 | Professional | None | $2,041.74 | $2,818.38 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $1,819.70 Typical High $2,951.21 | Professional | None | $251.19 | $1,819.70 | $2,951.21 |
SummaCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,137.96 | $3,235.94 |
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 $2,041.74 Median $2,754.23 Typical High $5,370.32 | Professional | None | $2,041.74 | $2,754.23 | $5,370.32 |
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 $977.24 Median $977.24 Typical High $4,466.84 | Professional | 52 · Reduced service | $977.24 | $977.24 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $1,819.70 | Professional | 53 · Discontinued | $389.05 | $389.05 | $1,819.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $6,760.83 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $1,348.96 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $891.25 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,230.27 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,023.29 | $1,230.27 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $316.23 Typical High $537.03 | Professional | 80 · Assistant surgeon | $257.04 | $316.23 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $467.74 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $467.74 |
Where Ohio sits
The same service costs 12.0 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
$2,042
AK $8,913TX $741
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.