How much rates vary
Facilitymedian $3,388 · 10th to 90th $708 to $10,000Professionalmedian $1,122 · 10th to 90th $135 to $1,778
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 $1,230.27 Median $1,230.27 Typical High $7,762.47 | Professional | None | $1,230.27 | $1,230.27 | $7,762.47 |
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 $1,000.00 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,258.93 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $208.93 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $162.18 | $208.93 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $3,019.95 Typical High $3,890.45 | Facility | None | $1,698.24 | $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 $1,318.26 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,778.28 | $2,511.89 |
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 $1,318.26 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,778.28 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $933.25 Typical High $1,548.82 | Professional | None | $107.15 | $933.25 | $1,548.82 |
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 $1,148.15 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,258.93 | $1,659.59 |
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 $851.14 Median $1,445.44 Typical High $2,511.89 | Professional | None | $851.14 | $1,445.44 | $2,511.89 |
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 $616.60 Median $616.60 Typical High $3,311.31 | Professional | 52 · Reduced service | $616.60 | $616.60 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $1,318.26 | Professional | 53 · Discontinued | $245.47 | $245.47 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $4,897.79 | Professional | 54 · Surgery only | $912.01 | $912.01 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $1,000.00 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $660.69 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $794.33 Typical High $1,288.25 | Professional | 62 · Two surgeons | $630.96 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $288.40 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $288.40 |
Where Ohio sits
The same service costs 7.2 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
$1,122
AK $5,495TX $759
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.