How much rates vary
Facilitymedian $1,445 · 10th to 90th $617 to $7,762Professionalmedian $776 · 10th to 90th $110 to $1,202
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 $794.33 Median $794.33 Typical High $9,120.11 | Professional | None | $794.33 | $794.33 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,230.27 Typical High $4,786.30 | Facility | None | $575.44 | $1,230.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,174.90 | Professional | None | $660.69 | $812.83 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $512.86 Typical High $741.31 | Professional | 62 · Two surgeons | $416.87 | $512.86 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $128.82 Typical High $194.98 | Professional | 80 · Assistant surgeon | $104.71 | $128.82 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $165.96 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,230.27 | Facility | None | $954.99 | $1,122.02 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,202.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,513.56 | Professional | None | $758.58 | $891.25 | $1,513.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,202.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,513.56 | Professional | None | $758.58 | $891.25 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $660.69 Typical High $1,071.52 | Professional | None | $77.62 | $660.69 | $1,071.52 |
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 $851.14 Median $851.14 Typical High $1,096.48 | Professional | None | $851.14 | $851.14 | $1,096.48 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,737.80 | Professional | None | $660.69 | $912.01 | $1,737.80 |
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 $398.11 Median $398.11 Typical High $1,819.70 | Professional | 52 · Reduced service | $398.11 | $398.11 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $724.44 | Professional | 53 · Discontinued | $158.49 | $158.49 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $2,754.23 | Professional | 54 · Surgery only | $588.84 | $588.84 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $549.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $363.08 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $2,570.40 |
Where Ohio sits
The same service costs 7.6 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
$794
AK $3,715TX $490
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.