How much rates vary
Facilitymedian $2,188 · 10th to 90th $741 to $10,965Professionalmedian $1,660 · 10th to 90th $257 to $2,818
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 $1,995.26 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,995.26 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $9,120.11 | Professional | None | $1,995.26 | $1,995.26 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,467.37 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,890.45 | Professional | None | $1,995.26 | $2,511.89 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $398.11 Typical High $1,995.26 | Professional | 80 · Assistant surgeon | $323.59 | $398.11 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,202.26 Typical High $2,398.83 | Facility | None | $588.84 | $1,202.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,630.27 | $3,801.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $1,202.26 Typical High $2,398.83 | Facility | None | $588.84 | $1,202.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,630.27 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $1,258.93 Typical High $2,187.76 | Professional | None | $213.80 | $1,258.93 | $2,187.76 |
SummaCare Setting Facility Modifier None Typical Low $575.44 Median $602.56 Typical High $676.08 | Facility | None | $575.44 | $602.56 | $676.08 |
SummaCare Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,862.09 | $2,454.71 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,311.31 Typical High $10,471.29 | Facility | None | $912.01 | $3,311.31 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,288.25 | $2,290.87 | $3,890.45 |
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 $1,000.00 Median $1,000.00 Typical High $4,168.69 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $1,698.24 | Professional | 53 · Discontinued | $398.11 | $398.11 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $6,309.57 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $1,258.93 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $831.76 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,584.89 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,258.93 | $1,584.89 | $2,454.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $346.74 Typical High $549.54 | Professional | AS · PA/NP assist | $281.84 | $346.74 | $549.54 |
Where Ohio sits
The same service costs 19.5 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· 47th of 51
$1,698
AK $8,318TX $427
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.