How much rates vary
Facilitymedian $3,715 · 10th to 90th $501 to $20,893Professionalmedian $759 · 10th to 90th $115 to $1,202
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 $831.76 Median $831.76 Typical High $3,630.78 | Professional | None | $831.76 | $831.76 | $3,630.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $9,772.37 Typical High $22,908.68 | Facility | None | $1,047.13 | $9,772.37 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,412.54 | Professional | None | $630.96 | $776.25 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $933.25 Median $1,202.26 Typical High $1,584.89 | Professional | None | $933.25 | $1,202.26 | $1,584.89 |
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 $933.25 Median $1,202.26 Typical High $1,584.89 | Professional | None | $933.25 | $1,202.26 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $645.65 Typical High $1,071.52 | Professional | None | $104.71 | $645.65 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,174.90 | Professional | None | $812.83 | $891.25 | $1,174.90 |
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 $575.44 Median $977.24 Typical High $1,698.24 | Professional | None | $575.44 | $977.24 | $1,698.24 |
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 $416.87 Median $416.87 Typical High $1,548.82 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $616.60 | Professional | 53 · Discontinued | $165.96 | $165.96 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $2,344.23 | Professional | 54 · Surgery only | $616.60 | $616.60 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $467.74 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $309.03 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $489.78 Typical High $891.25 | Professional | 62 · Two surgeons | $389.05 | $489.78 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $125.89 Typical High $218.78 | Professional | 80 · Assistant surgeon | $100.00 | $125.89 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $109.65 Typical High $194.98 | Professional | AS · PA/NP assist | $87.10 | $109.65 | $194.98 |
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· 47th of 51
$776
AK $3,715TX $155
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.