How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $2,291 · 10th to 90th $347 to $3,715
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 $2,290.87 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,290.87 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $9,332.54 | Professional | None | $2,290.87 | $2,290.87 | $9,332.54 |
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 $1,819.70 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,819.70 | $2,344.23 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $2,344.23 Median $3,311.31 Typical High $5,370.32 | Professional | None | $2,344.23 | $3,311.31 | $5,370.32 |
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 $2,344.23 Median $3,311.31 Typical High $5,370.32 | Professional | None | $2,344.23 | $3,311.31 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $2,089.30 Typical High $3,388.44 | Professional | None | $316.23 | $2,089.30 | $3,388.44 |
SummaCare Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,715.35 | Professional | None | $2,454.71 | $2,454.71 | $3,715.35 |
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 $2,238.72 Median $3,090.30 Typical High $6,165.95 | Professional | None | $2,238.72 | $3,090.30 | $6,165.95 |
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 $1,148.15 Median $1,148.15 Typical High $3,981.07 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $1,584.89 | Professional | 53 · Discontinued | $457.09 | $457.09 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $6,025.60 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $1,202.26 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $794.33 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,479.11 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,148.15 | $1,479.11 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $380.19 Typical High $645.65 | Professional | 80 · Assistant surgeon | $295.12 | $380.19 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $331.13 Typical High $549.54 | Professional | AS · PA/NP assist | $257.04 | $331.13 | $549.54 |
Where Ohio sits
The same service costs 10.0 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
$2,344
AK $10,233TX $1,023
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.