How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $12,589Professionalmedian $1,479 · 10th to 90th $123 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 $1,698.24 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,698.24 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $10,232.93 | Professional | None | $1,698.24 | $1,698.24 | $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 $1,230.27 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,548.82 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $954.99 Typical High $1,737.80 | Professional | 62 · Two surgeons | $776.25 | $954.99 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $245.47 Typical High $467.74 | Professional | 80 · Assistant surgeon | $194.98 | $245.47 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $213.80 Typical High $389.05 | Professional | AS · PA/NP assist | $169.82 | $213.80 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $1,479.11 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,862.09 | $3,388.44 |
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 $1,479.11 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,862.09 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,288.25 Typical High $1,819.70 | Professional | None | $114.82 | $1,288.25 | $1,819.70 |
SummaCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,621.81 | $2,818.38 |
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 $1,584.89 Median $1,995.26 Typical High $4,466.84 | Professional | None | $1,584.89 | $1,995.26 | $4,466.84 |
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 $831.76 Median $831.76 Typical High $2,344.23 | Professional | 52 · Reduced service | $831.76 | $831.76 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $933.25 | Professional | 53 · Discontinued | $338.84 | $338.84 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $707.95 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $467.74 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $3,311.31 |
Where Ohio sits
The same service costs 5.6 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· 48th of 51
$1,479
AK $6,026TX $1,072
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.