How much rates vary
Facilitymedian $4,074 · 10th to 90th $661 to $12,882Professionalmedian $1,349 · 10th to 90th $1,047 to $2,239
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $6,606.93 | Professional | None | $1,071.52 | $1,071.52 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,445.44 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,137.96 Typical High $3,467.37 | Professional | 50 · Both sides | $1,737.80 | $2,137.96 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $229.09 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $186.21 | $229.09 | $1,148.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $199.53 Typical High $331.13 | Professional | AS · PA/NP assist | $162.18 | $199.53 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $8,912.51 Typical High $15,135.61 | Facility | None | $549.54 | $8,912.51 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,348.96 | $1,949.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $8,912.51 Typical High $14,454.40 | Facility | None | $549.54 | $8,912.51 | $14,454.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,348.96 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,888.44 | Facility | None | $4,897.79 | $5,128.61 | $5,888.44 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
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 $676.08 Median $1,288.25 Typical High $2,137.96 | Professional | None | $676.08 | $1,288.25 | $2,137.96 |
6 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 $524.81 Median $524.81 Typical High $1,288.25 | Professional | 52 · Reduced service | $524.81 | $524.81 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $512.86 | Professional | 53 · Discontinued | $213.80 | $213.80 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $1,949.84 | Professional | 54 · Surgery only | $794.33 | $794.33 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $389.05 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $257.04 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $1,819.70 |
Where Ohio sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 31st of 51
$1,445
AK $4,467HI $95.50
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.