How much rates vary
Facilitymedian $6,026 · 10th to 90th $501 to $23,442Professionalmedian $1,514 · 10th to 90th $234 to $2,399
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 $1,548.82 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,548.82 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $7,762.47 | Professional | None | $1,548.82 | $1,548.82 | $7,762.47 |
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 $1,148.15 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,445.44 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $234.42 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $186.21 | $234.42 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,819.70 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,819.70 | $2,238.72 | $2,951.21 |
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 $1,819.70 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,819.70 | $2,238.72 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,412.54 Typical High $2,187.76 | Professional | None | $199.53 | $1,412.54 | $2,187.76 |
SummaCare Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,737.80 | $2,238.72 |
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 $1,071.52 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,778.28 | $3,090.30 |
8 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 $776.25 Median $776.25 Typical High $3,388.44 | Professional | 52 · Reduced service | $776.25 | $776.25 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $1,348.96 | Professional | 53 · Discontinued | $309.03 | $309.03 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $5,011.87 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $1,000.00 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $676.08 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $912.01 Typical High $1,513.56 | Professional | 62 · Two surgeons | $724.44 | $912.01 | $1,513.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $199.53 Typical High $338.84 | Professional | AS · PA/NP assist | $162.18 | $199.53 | $338.84 |
Where Ohio sits
The same service costs 6.0 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· 47th of 51
$1,549
AK $7,079TX $1,175
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.