How much rates vary
Facilitymedian $2,344 · 10th to 90th $617 to $8,710Professionalmedian $1,000 · 10th to 90th $123 to $1,514
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 $1,862.09 Median $4,570.88 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,570.88 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $4,570.88 | Professional | None | $1,000.00 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,737.80 | Professional | None | $831.76 | $1,047.13 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $173.78 Typical High $831.76 | Professional | 80 · Assistant surgeon | $131.83 | $173.78 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $144.54 Typical High $239.88 | Professional | AS · PA/NP assist | $117.49 | $144.54 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $3,019.95 Typical High $3,890.45 | Facility | None | $1,380.38 | $3,019.95 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,137.96 Typical High $3,311.31 | Facility | None | $489.78 | $2,137.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,445.44 | $2,089.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $3,235.94 | Facility | None | $512.86 | $2,137.96 | $3,235.94 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,445.44 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $851.14 Typical High $1,318.26 | Professional | None | $100.00 | $851.14 | $1,318.26 |
SummaCare Setting Facility Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,348.96 | Facility | None | $1,122.02 | $1,174.90 | $1,348.96 |
SummaCare Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $933.25 | $1,047.13 | $1,348.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,174.90 Typical High $2,041.74 | Professional | None | $707.95 | $1,174.90 | $2,041.74 |
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 $501.19 Median $501.19 Typical High $1,949.84 | Professional | 52 · Reduced service | $501.19 | $501.19 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $776.25 | Professional | 53 · Discontinued | $199.53 | $199.53 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $2,951.21 | Professional | 54 · Surgery only | $741.31 | $741.31 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $588.84 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $389.05 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $2,754.23 |
Where Ohio sits
The same service costs 6.2 times more in Alaska than in Utah. 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
$1,000
AK $4,571UT $741
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.