How much rates vary
Facilitymedian $6,026 · 10th to 90th $501 to $23,442Professionalmedian $1,349 · 10th to 90th $182 to $2,188
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 $1,445.44 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,445.44 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $6,165.95 | Professional | None | $1,445.44 | $1,445.44 | $6,165.95 |
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 $1,096.48 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,348.96 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,202.26 Typical High $6,760.83 | Facility | None | $426.58 | $1,202.26 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,089.30 | $2,754.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $1,318.26 Typical High $6,760.83 | Facility | None | $426.58 | $1,318.26 | $6,760.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,089.30 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,148.15 Typical High $1,949.84 | Professional | None | $165.96 | $1,148.15 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,621.81 | $2,089.30 |
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 $1,000.00 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,659.59 | $2,884.03 |
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 $724.44 Median $724.44 Typical High $2,691.53 | Professional | 52 · Reduced service | $724.44 | $724.44 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $1,071.52 | Professional | 53 · Discontinued | $288.40 | $288.40 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $3,981.07 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $794.33 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $537.03 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $851.14 Typical High $1,479.11 | Professional | 62 · Two surgeons | $691.83 | $851.14 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $218.78 Typical High $380.19 | Professional | 80 · Assistant surgeon | $173.78 | $218.78 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $190.55 Typical High $338.84 | Professional | AS · PA/NP assist | $151.36 | $190.55 | $338.84 |
Where Ohio sits
The same service costs 22.9 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· 47th of 51
$1,349
AK $6,607TX $288
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.