How much rates vary
Facilitymedian $1,862 · 10th to 90th $447 to $12,589Professionalmedian $1,950 · 10th to 90th $209 to $3,090
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 $2,290.87 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,290.87 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $10,232.93 | Professional | None | $2,290.87 | $2,290.87 | $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 $1,348.96 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,737.80 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,096.48 Typical High $1,862.09 | Professional | 62 · Two surgeons | $851.14 | $1,096.48 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $275.42 Typical High $489.78 | Professional | 80 · Assistant surgeon | $213.80 | $275.42 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $245.47 Typical High $416.87 | Professional | AS · PA/NP assist | $190.55 | $245.47 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $2,041.74 Median $2,511.89 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,511.89 | $4,677.35 |
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 $2,041.74 Median $2,511.89 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,511.89 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,862.09 Typical High $2,511.89 | Professional | None | $186.21 | $1,862.09 | $2,511.89 |
SummaCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,137.96 | $3,715.35 |
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 $2,041.74 Median $2,691.53 Typical High $6,025.60 | Professional | None | $2,041.74 | $2,691.53 | $6,025.60 |
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 $1,122.02 Median $1,122.02 Typical High $3,630.78 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $1,445.44 | Professional | 53 · Discontinued | $457.09 | $457.09 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $5,370.32 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $1,071.52 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $724.44 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $5,011.87 |
Where Ohio sits
The same service costs 5.4 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
$1,950
AK $8,128TX $1,514
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.