How much rates vary
Facilitymedian $1,585 · 10th to 90th $447 to $10,715Professionalmedian $1,318 · 10th to 90th $123 to $2,042
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 $1,513.56 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,513.56 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $10,232.93 | Professional | None | $1,513.56 | $1,513.56 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,398.83 Typical High $9,772.37 | Facility | None | $954.99 | $2,398.83 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,348.96 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $851.14 Typical High $1,348.96 | Professional | 62 · Two surgeons | $691.83 | $851.14 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $218.78 Typical High $363.08 | Professional | 80 · Assistant surgeon | $177.83 | $218.78 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $190.55 Typical High $302.00 | Professional | AS · PA/NP assist | $154.88 | $190.55 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,659.59 | $2,951.21 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,659.59 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,174.90 Typical High $1,659.59 | Professional | None | $114.82 | $1,174.90 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,479.11 | $2,570.40 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $3,981.07 | Professional | None | $1,412.54 | $1,778.28 | $3,981.07 |
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 $741.31 Median $741.31 Typical High $2,630.27 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $1,047.13 | Professional | 53 · Discontinued | $302.00 | $302.00 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $3,890.45 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $776.25 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $524.81 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $3,630.78 |
Where Ohio sits
The same service costs 5.4 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
$1,349
AK $5,370TX $1,000
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.