How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $10,233Professionalmedian $1,514 · 10th to 90th $224 to $2,455
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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $8,128.31 | Professional | None | $1,862.09 | $1,862.09 | $8,128.31 |
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 $1,584.89 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,995.26 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $323.59 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $251.19 | $323.59 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,715.35 Typical High $6,165.95 | Facility | None | $588.84 | $3,715.35 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,454.71 | $3,715.35 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $3,801.89 Typical High $5,754.40 | Facility | None | $588.84 | $3,801.89 | $5,754.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,454.71 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,148.15 Typical High $1,995.26 | Professional | None | $177.83 | $1,148.15 | $1,995.26 |
SummaCare Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,344.23 | Facility | None | $1,995.26 | $2,089.30 | $2,344.23 |
SummaCare Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,698.24 | $2,238.72 |
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 $1,202.26 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,202.26 | $2,089.30 | $3,630.78 |
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 $933.25 Median $933.25 Typical High $3,548.13 | Professional | 52 · Reduced service | $933.25 | $933.25 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $1,445.44 | Professional | 53 · Discontinued | $380.19 | $380.19 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $5,370.32 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $1,071.52 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $724.44 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,258.93 Typical High $1,949.84 | Professional | 62 · Two surgeons | $1,000.00 | $1,258.93 | $1,949.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $275.42 Typical High $436.52 | Professional | AS · PA/NP assist | $223.87 | $275.42 | $436.52 |
Where Ohio sits
The same service costs 21.9 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
$1,549
AK $7,943TX $363
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.