How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $10,233Professionalmedian $1,698 · 10th to 90th $257 to $2,951
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 $2,884.03 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,884.03 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $8,709.64 | Professional | None | $2,238.72 | $2,238.72 | $8,709.64 |
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 $1,698.24 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,137.96 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $346.74 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $275.42 | $346.74 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,801.89 Typical High $6,165.95 | Facility | None | $588.84 | $3,801.89 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $4,265.80 | Professional | None | $2,238.72 | $2,951.21 | $4,265.80 |
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 $2,238.72 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,951.21 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $1,348.96 Typical High $2,398.83 | Professional | None | $213.80 | $1,348.96 | $2,398.83 |
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 $1,862.09 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,862.09 | $2,041.74 | $2,691.53 |
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 $1,445.44 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,445.44 | $2,398.83 | $4,168.69 |
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 $1,096.48 Median $1,096.48 Typical High $3,890.45 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $1,548.82 | Professional | 53 · Discontinued | $446.68 | $446.68 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $5,754.40 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $1,148.15 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $776.25 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,348.96 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,071.52 | $1,348.96 | $2,187.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $302.00 Typical High $489.78 | Professional | AS · PA/NP assist | $239.88 | $302.00 | $489.78 |
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· 48th of 51
$1,738
AK $9,333TX $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.