How much rates vary
Facilitymedian $2,884 · 10th to 90th $724 to $10,233Professionalmedian $724 · 10th to 90th $89 to $1,175
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 $2,454.71 Median $7,762.47 Typical High $12,589.25 | Facility | None | $2,454.71 | $7,762.47 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $10,471.29 | Professional | None | $891.25 | $891.25 | $10,471.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,380.38 | Professional | None | $691.83 | $851.14 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $141.25 Typical High $691.83 | Professional | 80 · Assistant surgeon | $109.65 | $141.25 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,122.02 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $5,011.87 | Facility | None | $549.54 | $2,884.03 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,621.81 | Professional | None | $891.25 | $1,148.15 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $4,897.79 | Facility | None | $549.54 | $2,884.03 | $4,897.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,621.81 | Professional | None | $891.25 | $1,148.15 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $588.84 Typical High $1,000.00 | Professional | None | $70.79 | $588.84 | $1,000.00 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,096.48 | Professional | None | $758.58 | $831.76 | $1,096.48 |
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 $575.44 Median $954.99 Typical High $1,659.59 | Professional | None | $575.44 | $954.99 | $1,659.59 |
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 $436.52 Median $436.52 Typical High $5,011.87 | Professional | 52 · Reduced service | $436.52 | $436.52 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $1,995.26 | Professional | 53 · Discontinued | $177.83 | $177.83 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $7,413.10 | Professional | 54 · Surgery only | $660.69 | $660.69 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $1,479.11 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $537.03 Typical High $851.14 | Professional | 62 · Two surgeons | $436.52 | $537.03 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $120.23 Typical High $190.55 | Professional | AS · PA/NP assist | $95.50 | $120.23 | $190.55 |
Where Ohio sits
The same service costs 20.0 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
$741
AK $3,715TX $186
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.