How much rates vary
Facilitymedian $4,169 · 10th to 90th $955 to $11,220Professionalmedian $661 · 10th to 90th $89 to $1,096
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 $10,000.00 Typical High $13,803.84 | Facility | None | $2,884.03 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $8,317.64 | Professional | None | $812.83 | $812.83 | $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 $645.65 Median $812.83 Typical High $1,230.27 | Professional | None | $645.65 | $812.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $645.65 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,023.29 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $4,897.79 Typical High $7,585.78 | Facility | None | $1,071.52 | $4,897.79 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,584.89 | Professional | None | $831.76 | $1,071.52 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,096.48 Median $5,011.87 Typical High $7,413.10 | Facility | None | $1,096.48 | $5,011.87 | $7,413.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,584.89 | Professional | None | $831.76 | $1,071.52 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $524.81 Typical High $933.25 | Professional | None | $70.79 | $524.81 | $933.25 |
SummaCare Setting Facility Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $3,090.30 | Facility | None | $2,570.40 | $2,691.53 | $3,090.30 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,023.29 | Professional | None | $707.95 | $776.25 | $1,023.29 |
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 $537.03 Median $891.25 Typical High $1,548.82 | Professional | None | $537.03 | $891.25 | $1,548.82 |
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 $407.38 Median $407.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $549.54 | Professional | 53 · Discontinued | $162.18 | $162.18 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $2,041.74 | Professional | 54 · Surgery only | $616.60 | $616.60 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $407.38 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $275.42 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $173.78 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $173.78 |
Where Ohio sits
The same service costs 17.8 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
$692
AK $3,388TX $191
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.