How much rates vary
Facilitymedian $1,585 · 10th to 90th $447 to $10,715Professionalmedian $1,175 · 10th to 90th $83 to $1,862
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 $1,288.25 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,288.25 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $10,232.93 | Professional | None | $1,288.25 | $1,288.25 | $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 $1,000.00 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,230.27 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $794.33 Typical High $1,380.38 | Professional | 62 · Two surgeons | $630.96 | $794.33 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $363.08 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $309.03 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $1,148.15 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,445.44 | $2,570.40 |
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 $1,148.15 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,445.44 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $1,047.13 Typical High $1,445.44 | Professional | None | $77.62 | $1,047.13 | $1,445.44 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,288.25 | $2,238.72 |
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 $1,230.27 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,548.82 | $3,467.37 |
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 $645.65 Median $645.65 Typical High $1,862.09 | Professional | 52 · Reduced service | $645.65 | $645.65 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $741.31 | Professional | 53 · Discontinued | $263.03 | $263.03 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $2,754.23 | Professional | 54 · Surgery only | $977.24 | $977.24 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $549.54 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $371.54 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $2,570.40 |
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· 48th of 51
$1,175
AK $4,677TX $851
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.