How much rates vary
Facilitymedian $2,291 · 10th to 90th $447 to $12,589Professionalmedian $3,090 · 10th to 90th $251 to $4,898
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 $5,370.32 Median $10,232.93 Typical High $12,589.25 | Facility | None | $5,370.32 | $10,232.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $13,803.84 | Professional | None | $3,548.13 | $3,548.13 | $13,803.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $5,011.87 | Professional | None | $2,630.27 | $3,090.30 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $1,949.84 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,659.59 | $1,949.84 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $489.78 Typical High $812.83 | Professional | 80 · Assistant surgeon | $416.87 | $489.78 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $426.58 Typical High $707.95 | Professional | AS · PA/NP assist | $363.08 | $426.58 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
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 $3,162.28 Median $3,981.07 Typical High $7,244.36 | Professional | None | $3,162.28 | $3,981.07 | $7,244.36 |
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 $3,162.28 Median $3,981.07 Typical High $7,244.36 | Professional | None | $3,162.28 | $3,981.07 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $2,691.53 Typical High $3,890.45 | Professional | None | $229.09 | $2,691.53 | $3,890.45 |
SummaCare Setting Professional Modifier None Typical Low $3,090.30 Median $3,388.44 Typical High $5,888.44 | Professional | None | $3,090.30 | $3,388.44 | $5,888.44 |
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 $3,235.94 Median $4,168.69 Typical High $9,549.93 | Professional | None | $3,235.94 | $4,168.69 | $9,549.93 |
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 $1,778.28 Median $1,778.28 Typical High $7,079.46 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $7,079.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $2,818.38 | Professional | 53 · Discontinued | $707.95 | $707.95 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $10,471.29 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $10,471.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $2,089.30 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $2,089.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $9,772.37 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $9,772.37 |
Where Ohio sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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
$3,090
AK $12,589AR $1,995
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.