How much rates vary
Facilitymedian $1,202 · 10th to 90th $447 to $10,233Professionalmedian $794 · 10th to 90th $81 to $1,230
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $10,232.93 | Professional | None | $851.14 | $851.14 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $7,585.78 | Facility | None | $645.65 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,258.93 | Professional | None | $645.65 | $758.58 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $794.33 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $204.17 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $177.83 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
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 $758.58 Median $954.99 Typical High $1,737.80 | Professional | None | $758.58 | $954.99 | $1,737.80 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,737.80 | Professional | None | $758.58 | $977.24 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $758.58 Typical High $1,023.29 | Professional | None | $70.79 | $758.58 | $1,023.29 |
SummaCare Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,513.56 | Professional | None | $794.33 | $870.96 | $1,513.56 |
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 $812.83 Median $1,023.29 Typical High $2,290.87 | Professional | None | $812.83 | $1,023.29 | $2,290.87 |
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 $426.58 Median $426.58 Typical High $1,230.27 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $489.78 | Professional | 53 · Discontinued | $169.82 | $169.82 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $1,862.09 | Professional | 54 · Surgery only | $645.65 | $645.65 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $371.54 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $245.47 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,737.80 |
Where Ohio sits
The same service costs 4.6 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· 49th of 51
$813
AK $3,162TX $692
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.