How much rates vary
Facilitymedian $1,862 · 10th to 90th $447 to $12,589Professionalmedian $2,138 · 10th to 90th $209 to $3,311
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 $2,398.83 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,398.83 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $10,232.93 | Professional | None | $2,398.83 | $2,398.83 | $10,232.93 |
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 $1,659.59 Median $1,949.84 Typical High $3,467.37 | Professional | None | $1,659.59 | $1,949.84 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,230.27 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,047.13 | $1,230.27 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $309.03 Typical High $537.03 | Professional | 80 · Assistant surgeon | $263.03 | $309.03 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $478.63 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $2,137.96 Median $2,630.27 Typical High $4,786.30 | Professional | None | $2,137.96 | $2,630.27 | $4,786.30 |
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 $2,137.96 Median $2,630.27 Typical High $4,786.30 | Professional | None | $2,137.96 | $2,630.27 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,995.26 Typical High $2,691.53 | Professional | None | $186.21 | $1,995.26 | $2,691.53 |
SummaCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,290.87 | $3,981.07 |
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 $2,089.30 Median $2,818.38 Typical High $6,456.54 | Professional | None | $2,089.30 | $2,818.38 | $6,456.54 |
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 $1,202.26 Median $1,202.26 Typical High $3,311.31 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $1,318.26 | Professional | 53 · Discontinued | $478.63 | $478.63 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $1,000.00 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $660.69 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $4,677.35 |
Where Ohio sits
The same service costs 5.2 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
$2,138
AK $8,710TX $1,660
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.