How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $2,344 · 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 $2,344.23 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,344.23 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $9,120.11 | Professional | None | $2,344.23 | $2,344.23 | $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 $1,621.81 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,041.74 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $323.59 Typical High $588.84 | Professional | 80 · Assistant surgeon | $263.03 | $323.59 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $288.40 Typical High $512.86 | Professional | AS · PA/NP assist | $229.09 | $288.40 | $512.86 |
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 $2,398.83 Median $3,162.28 Typical High $5,128.61 | Professional | None | $2,398.83 | $3,162.28 | $5,128.61 |
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 $3,235.94 Typical High $5,128.61 | Professional | None | $2,398.83 | $3,235.94 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $2,137.96 Typical High $3,388.44 | Professional | None | $316.23 | $2,137.96 | $3,388.44 |
SummaCare Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,511.89 | $2,511.89 | $3,311.31 |
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 $2,137.96 Median $2,818.38 Typical High $6,309.57 | Professional | None | $2,137.96 | $2,818.38 | $6,309.57 |
6 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 $3,235.94 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $1,318.26 | Professional | 53 · Discontinued | $467.74 | $467.74 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $977.24 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $660.69 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $4,570.88 |
Where Ohio sits
The same service costs 17.4 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· 45th of 51
$2,344
AK $10,471TX $603
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.