How much rates vary
Facilitymedian $2,818 · 10th to 90th $933 to $10,233Professionalmedian $575 · 10th to 90th $89 to $933
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 $1,949.84 Median $8,317.64 Typical High $13,182.57 | Facility | None | $1,949.84 | $8,317.64 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $8,317.64 | Professional | None | $707.95 | $707.95 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $7,943.28 | Facility | None | $933.25 | $2,238.72 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,071.52 | Professional | None | $549.54 | $676.08 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $112.20 Typical High $549.54 | Professional | 80 · Assistant surgeon | $87.10 | $112.20 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $3,630.78 | Facility | None | $912.01 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,047.13 | $3,235.94 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,348.96 | Professional | None | $724.44 | $933.25 | $1,348.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,071.52 | $3,235.94 | $5,248.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,318.26 | Professional | None | $724.44 | $933.25 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $467.74 Typical High $794.33 | Professional | None | $70.79 | $467.74 | $794.33 |
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 $616.60 Median $676.08 Typical High $891.25 | Professional | None | $616.60 | $676.08 | $891.25 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,348.96 | Professional | None | $467.74 | $776.25 | $1,348.96 |
7 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 $354.81 Median $354.81 Typical High $1,202.26 | Professional | 52 · Reduced service | $354.81 | $354.81 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $478.63 | Professional | 53 · Discontinued | $141.25 | $141.25 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $1,819.70 | Professional | 54 · Surgery only | $537.03 | $537.03 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $363.08 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $239.88 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $95.50 Typical High $151.36 | Professional | AS · PA/NP assist | $75.86 | $95.50 | $151.36 |
Where Ohio sits
The same service costs 8.5 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· 48th of 51
$603
AK $3,020TX $355
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.