How much rates vary
Facilitymedian $1,349 · 10th to 90th $575 to $8,511Professionalmedian $2,344 · 10th to 90th $363 to $3,631
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 $2,884.03 Median $8,709.64 Typical High $13,803.84 | Facility | None | $2,884.03 | $8,709.64 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $12,882.50 | Professional | None | $2,344.23 | $2,344.23 | $12,882.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,715.35 | Professional | None | $2,089.30 | $2,570.40 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,621.81 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,318.26 | $1,621.81 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $407.38 Typical High $616.60 | Professional | 80 · Assistant surgeon | $338.84 | $407.38 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $354.81 Typical High $537.03 | Professional | AS · PA/NP assist | $295.12 | $354.81 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $3,311.31 | Facility | None | $954.99 | $1,230.27 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $2,951.21 | Facility | None | $741.31 | $1,202.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $4,677.35 | Professional | None | $2,290.87 | $2,630.27 | $4,677.35 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $2,951.21 | Facility | None | $741.31 | $1,202.26 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,290.87 | $2,570.40 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $1,737.80 Typical High $2,951.21 | Professional | None | $269.15 | $1,737.80 | $2,951.21 |
SummaCare Setting Facility Modifier None Typical Low $575.44 Median $616.60 Typical High $691.83 | Facility | None | $575.44 | $616.60 | $691.83 |
SummaCare Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,398.83 | $3,162.28 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $5,128.61 | Professional | None | $2,041.74 | $2,754.23 | $5,128.61 |
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 $1,174.90 Median $1,174.90 Typical High $6,456.54 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $6,456.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $2,570.40 | Professional | 53 · Discontinued | $467.74 | $467.74 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $9,549.93 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $9,549.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $1,905.46 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $8,912.51 |
Where Ohio sits
The same service costs 15.8 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· 44th of 51
$2,344
AK $8,128TX $513
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.