How much rates vary
Facilitymedian $2,512 · 10th to 90th $617 to $9,120Professionalmedian $437 · 10th to 90th $251 to $661
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 $588.84 Median $10,232.93 Typical High $13,803.84 | Facility | None | $588.84 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $3,715.35 | Professional | None | $446.68 | $446.68 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $7,079.46 | Facility | None | $724.44 | $2,137.96 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $537.03 | Professional | None | $213.80 | $288.40 | $537.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $134.90 Median $181.97 Typical High $338.84 | Professional | 62 · Two surgeons | $134.90 | $181.97 | $338.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $45.71 Typical High $95.50 | Professional | 80 · Assistant surgeon | $34.67 | $45.71 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $38.90 Typical High $75.86 | Professional | AS · PA/NP assist | $30.20 | $38.90 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $1,174.90 Typical High $1,737.80 | Facility | None | $549.54 | $1,174.90 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $5,011.87 | Facility | None | $549.54 | $2,884.03 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $831.76 | Professional | None | $371.54 | $467.74 | $831.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $4,897.79 | Facility | None | $549.54 | $2,884.03 | $4,897.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $851.14 | Professional | None | $380.19 | $467.74 | $851.14 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $616.60 | Professional | None | $363.08 | $457.09 | $616.60 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $512.86 | Professional | None | $389.05 | $389.05 | $512.86 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $1,023.29 | Professional | None | $234.42 | $467.74 | $1,023.29 |
5 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 $223.87 Median $223.87 Typical High $616.60 | Professional | 52 · Reduced service | $223.87 | $223.87 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $245.47 | Professional | 53 · Discontinued | $89.13 | $89.13 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $912.01 | Professional | 54 · Surgery only | $331.13 | $331.13 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $181.97 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $123.03 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $123.03 |
Where Ohio sits
The same service costs 5.2 times more in Alaska 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.
Ohio· 46th of 51
$457
AK $1,820KY $347
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.