How much rates vary
Facilitymedian $3,631 · 10th to 90th $676 to $10,471Professionalmedian $1,096 · 10th to 90th $178 to $1,820
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $6,456.54 | Professional | None | $1,348.96 | $1,348.96 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $3,467.37 Typical High $12,022.64 | Facility | None | $676.08 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,288.25 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $346.74 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,698.24 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,888.44 | Facility | None | $602.56 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,737.80 | $2,511.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,623.41 | Facility | None | $602.56 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,737.80 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $870.96 Typical High $1,548.82 | Professional | None | $141.25 | $870.96 | $1,548.82 |
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 $1,202.26 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,318.26 | $1,737.80 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $2,454.71 | Professional | None | $851.14 | $1,445.44 | $2,454.71 |
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 $660.69 Median $660.69 Typical High $2,818.38 | Professional | 52 · Reduced service | $660.69 | $660.69 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $1,122.02 | Professional | 53 · Discontinued | $269.15 | $269.15 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $851.14 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $562.34 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $3,981.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $309.03 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $309.03 |
Where Ohio sits
The same service costs 17.0 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
$1,122
AK $5,623TX $331
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.