How much rates vary
Facilitymedian $4,169 · 10th to 90th $501 to $25,119Professionalmedian $1,549 · 10th to 90th $135 to $2,399
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 $1,778.28 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,778.28 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $10,232.93 | Professional | None | $1,778.28 | $1,778.28 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $11,748.98 Typical High $30,199.52 | Facility | None | $1,258.93 | $11,748.98 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,023.29 Typical High $1,621.81 | Professional | 62 · Two surgeons | $831.76 | $1,023.29 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $416.87 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,584.89 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,584.89 | $1,995.26 | $3,467.37 |
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 $1,584.89 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,584.89 | $1,995.26 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $1,380.38 Typical High $1,995.26 | Professional | None | $117.49 | $1,380.38 | $1,995.26 |
SummaCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,737.80 | $3,019.95 |
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 $1,659.59 Median $2,089.30 Typical High $4,786.30 | Professional | None | $1,659.59 | $2,089.30 | $4,786.30 |
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 $891.25 Median $891.25 Typical High $2,511.89 | Professional | 52 · Reduced service | $891.25 | $891.25 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $1,000.00 | Professional | 53 · Discontinued | $354.81 | $354.81 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $741.31 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $501.19 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $3,467.37 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $363.08 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $363.08 |
Where Ohio sits
The same service costs 5.5 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· 46th of 51
$1,585
AK $6,457TX $1,175
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.