How much rates vary
Facilitymedian $2,188 · 10th to 90th $741 to $9,120Professionalmedian $692 · 10th to 90th $110 to $1,047
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $9,120.11 | Professional | None | $691.83 | $691.83 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,698.24 Typical High $7,762.47 | Facility | None | $691.83 | $1,698.24 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,047.13 | Professional | None | $588.84 | $724.44 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $457.09 Typical High $660.69 | Professional | 62 · Two surgeons | $371.54 | $457.09 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $114.82 Typical High $173.78 | Professional | 80 · Assistant surgeon | $95.50 | $114.82 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $100.00 Typical High $147.91 | Professional | AS · PA/NP assist | $83.18 | $100.00 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $1,905.46 Typical High $2,454.71 | Facility | None | $977.24 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,311.31 | Facility | None | $741.31 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,318.26 | Professional | None | $660.69 | $812.83 | $1,318.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,311.31 | Facility | None | $741.31 | $2,041.74 | $3,311.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,318.26 | Professional | None | $660.69 | $776.25 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $537.03 Typical High $912.01 | Professional | None | $77.62 | $537.03 | $912.01 |
SummaCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,000.00 | $1,047.13 | $1,202.26 |
SummaCare Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $954.99 | Professional | None | $741.31 | $741.31 | $954.99 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,513.56 | Professional | None | $575.44 | $812.83 | $1,513.56 |
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 $346.74 Median $346.74 Typical High $1,584.89 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $630.96 | Professional | 53 · Discontinued | $138.04 | $138.04 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $2,344.23 | Professional | 54 · Surgery only | $512.86 | $512.86 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $467.74 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $316.23 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $2,187.76 |
Where Ohio sits
The same service costs 8.1 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· 49th of 51
$692
AK $3,236TX $398
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.