How much rates vary
Facilitymedian $1,995 · 10th to 90th $603 to $10,233Professionalmedian $501 · 10th to 90th $79 to $891
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 $512.86 Median $512.86 Typical High $3,548.13 | Professional | None | $512.86 | $512.86 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $7,585.78 | Facility | None | $588.84 | $1,778.28 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,288.25 | Professional | None | $630.96 | $851.14 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $134.90 Typical High $208.93 | Professional | 80 · Assistant surgeon | $100.00 | $134.90 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $117.49 Typical High $186.21 | Professional | AS · PA/NP assist | $87.10 | $117.49 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $1,513.56 Typical High $1,995.26 | Facility | None | $660.69 | $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 $524.81 Median $660.69 Typical High $1,047.13 | Professional | None | $524.81 | $660.69 | $1,047.13 |
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 $524.81 Median $660.69 Typical High $1,071.52 | Professional | None | $524.81 | $660.69 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $389.05 Typical High $630.96 | Professional | None | $67.61 | $389.05 | $630.96 |
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 $457.09 Median $501.19 Typical High $660.69 | Professional | None | $457.09 | $501.19 | $660.69 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $10,471.29 | Facility | None | $912.01 | $3,388.44 | $10,471.29 |
United Setting Professional Modifier None Typical Low $331.13 Median $660.69 Typical High $1,148.15 | Professional | None | $331.13 | $660.69 | $1,148.15 |
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 $257.04 Median $257.04 Typical High $891.25 | Professional | 52 · Reduced service | $257.04 | $257.04 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $354.81 | Professional | 53 · Discontinued | $102.33 | $102.33 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,348.96 | Professional | 54 · Surgery only | $389.05 | $389.05 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $269.15 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $177.83 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,258.93 |
Where Ohio sits
The same service costs 6.6 times more in Alaska than in Utah. 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
$513
AK $2,188UT $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.