How much rates vary
Facilitymedian $5,129 · 10th to 90th $501 to $23,442Professionalmedian $1,950 · 10th to 90th $282 to $3,162
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 $2,187.76 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,187.76 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $9,332.54 | Professional | None | $2,187.76 | $2,187.76 | $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 $1,584.89 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,584.89 | $1,949.84 | $3,311.31 |
CareSource Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $2,454.71 Median $3,162.28 Typical High $4,073.80 | Professional | None | $2,454.71 | $3,162.28 | $4,073.80 |
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 $2,511.89 Median $3,162.28 Typical High $3,981.07 | Professional | None | $2,511.89 | $3,162.28 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $1,737.80 Typical High $2,884.03 | Professional | None | $257.04 | $1,737.80 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,398.83 | $3,090.30 |
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 $1,513.56 Median $2,511.89 Typical High $4,365.16 | Professional | None | $1,513.56 | $2,511.89 | $4,365.16 |
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 $1,096.48 Median $1,096.48 Typical High $3,981.07 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $1,584.89 | Professional | 53 · Discontinued | $436.52 | $436.52 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $6,025.60 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $1,202.26 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $794.33 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,230.27 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,000.00 | $1,230.27 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $316.23 Typical High $537.03 | Professional | 80 · Assistant surgeon | $251.19 | $316.23 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $275.42 Typical High $467.74 | Professional | AS · PA/NP assist | $218.78 | $275.42 | $467.74 |
Where Ohio sits
The same service costs 24.0 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· 48th of 51
$1,950
AK $9,772TX $407
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.