How much rates vary
Facilitymedian $3,236 · 10th to 90th $501 to $11,749Professionalmedian $912 · 10th to 90th $135 to $1,479
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 $891.25 Median $891.25 Typical High $4,677.35 | Professional | None | $891.25 | $891.25 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $6,165.95 Typical High $12,882.50 | Facility | None | $933.25 | $6,165.95 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,584.89 | Professional | None | $724.44 | $912.01 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $144.54 Typical High $251.19 | Professional | 80 · Assistant surgeon | $114.82 | $144.54 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $125.89 Typical High $223.87 | Professional | AS · PA/NP assist | $100.00 | $125.89 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $954.99 Median $1,288.25 Typical High $1,995.26 | Professional | None | $954.99 | $1,288.25 | $1,995.26 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,041.74 | Professional | None | $954.99 | $1,288.25 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $851.14 Typical High $1,348.96 | Professional | None | $120.23 | $851.14 | $1,348.96 |
SummaCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,000.00 | $1,479.11 |
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 $2,454.71 | Professional | None | $933.25 | $1,258.93 | $2,454.71 |
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 $446.68 Median $446.68 Typical High $1,659.59 | Professional | 52 · Reduced service | $446.68 | $446.68 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $660.69 | Professional | 53 · Discontinued | $181.97 | $181.97 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $2,511.89 | Professional | 54 · Surgery only | $676.08 | $676.08 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $501.19 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $2,344.23 |
Where Ohio sits
The same service costs 6.8 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
$955
AK $4,074TX $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.