How much rates vary
Facilitymedian $3,467 · 10th to 90th $832 to $10,471Professionalmedian $708 · 10th to 90th $89 to $1,148
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 $1,862.09 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,862.09 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $5,754.40 | Professional | None | $851.14 | $851.14 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $7,585.78 | Facility | None | $645.65 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,230.27 | Professional | None | $602.56 | $741.31 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $120.23 Typical High $602.56 | Professional | 80 · Assistant surgeon | $95.50 | $120.23 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $1,230.27 | Facility | None | $630.96 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,890.45 Typical High $6,606.93 | Facility | None | $602.56 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,584.89 | Professional | None | $870.96 | $1,096.48 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,890.45 Typical High $6,606.93 | Facility | None | $602.56 | $3,890.45 | $6,606.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,584.89 | Professional | None | $870.96 | $1,096.48 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $575.44 Typical High $1,023.29 | Professional | None | $70.79 | $575.44 | $1,023.29 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,148.15 | Professional | None | $794.33 | $870.96 | $1,148.15 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $1,584.89 | Professional | None | $549.54 | $891.25 | $1,584.89 |
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 $426.58 Median $426.58 Typical High $891.25 | Professional | 52 · Reduced service | $426.58 | $426.58 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $354.81 | Professional | 53 · Discontinued | $169.82 | $169.82 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $1,348.96 | Professional | 54 · Surgery only | $645.65 | $645.65 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $269.15 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $177.83 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $467.74 Typical High $776.25 | Professional | 62 · Two surgeons | $371.54 | $467.74 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $104.71 Typical High $173.78 | Professional | AS · PA/NP assist | $83.18 | $104.71 | $173.78 |
Where Ohio sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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.
Physician feeFacility fee
OK $11,738KY $2,311
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.