How much rates vary
Facilitymedian $1,778 · 10th to 90th $550 to $6,918Professionalmedian $661 · 10th to 90th $87 to $1,072
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 $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $3,548.13 | Professional | None | $794.33 | $794.33 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $7,585.78 | Facility | None | $588.84 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,174.90 | Professional | None | $537.03 | $676.08 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $114.82 Typical High $537.03 | Professional | 80 · Assistant surgeon | $85.11 | $114.82 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,000.00 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $2,511.89 | Facility | None | $489.78 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,412.54 | Professional | None | $776.25 | $977.24 | $1,412.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $2,454.71 | Facility | None | $512.86 | $1,737.80 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,348.96 | Professional | None | $776.25 | $977.24 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $537.03 Typical High $954.99 | Professional | None | $70.79 | $537.03 | $954.99 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,047.13 | Professional | None | $724.44 | $794.33 | $1,047.13 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $1,445.44 | Professional | None | $489.78 | $794.33 | $1,445.44 |
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 $398.11 Median $398.11 Typical High $1,258.93 | Professional | 52 · Reduced service | $398.11 | $398.11 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $501.19 | Professional | 53 · Discontinued | $158.49 | $158.49 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $1,862.09 | Professional | 54 · Surgery only | $588.84 | $588.84 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $371.54 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $251.19 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $1,737.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $93.33 Typical High $162.18 | Professional | AS · PA/NP assist | $74.13 | $93.33 | $162.18 |
Where Ohio sits
The same service costs 8.3 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
$676
AK $3,388TX $407
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.