How much rates vary
Facilitymedian $3,388 · 10th to 90th $708 to $10,000Professionalmedian $1,148 · 10th to 90th $162 to $1,862
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $6,918.31 | Professional | None | $1,258.93 | $1,258.93 | $6,918.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $7,079.46 | Facility | None | $691.83 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,288.25 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $223.87 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $165.96 | $223.87 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $3,019.95 Typical High $3,890.45 | Facility | None | $1,778.28 | $3,019.95 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $6,309.57 | Facility | None | $602.56 | $3,981.07 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,862.09 | $2,570.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $6,165.95 | Facility | None | $602.56 | $3,981.07 | $6,165.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,862.09 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $954.99 Typical High $1,621.81 | Professional | None | $141.25 | $954.99 | $1,621.81 |
SummaCare Setting Facility Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,570.40 | Facility | None | $2,137.96 | $2,238.72 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,318.26 | $1,698.24 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $2,691.53 | Professional | None | $891.25 | $1,479.11 | $2,691.53 |
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 $630.96 Median $630.96 Typical High $2,630.27 | Professional | 52 · Reduced service | $630.96 | $630.96 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $1,071.52 | Professional | 53 · Discontinued | $257.04 | $257.04 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $3,981.07 | Professional | 54 · Surgery only | $954.99 | $954.99 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $794.33 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $524.81 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $812.83 Typical High $1,380.38 | Professional | 62 · Two surgeons | $645.65 | $812.83 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $309.03 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $309.03 |
Where Ohio sits
The same service costs 24.5 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
$1,175
AK $5,754TX $234
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.