How much rates vary
Facilitymedian $1,862 · 10th to 90th $447 to $12,589Professionalmedian $1,738 · 10th to 90th $166 to $2,754
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 $1,949.84 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,949.84 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $10,232.93 | Professional | None | $1,949.84 | $1,949.84 | $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 $1,479.11 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,819.70 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,148.15 Typical High $1,905.46 | Professional | 62 · Two surgeons | $933.25 | $1,148.15 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $288.40 Typical High $512.86 | Professional | 80 · Assistant surgeon | $234.42 | $288.40 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $251.19 Typical High $426.58 | Professional | AS · PA/NP assist | $204.17 | $251.19 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $1,737.80 Median $2,137.96 Typical High $3,981.07 | Professional | None | $1,737.80 | $2,137.96 | $3,981.07 |
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 $1,737.80 Median $2,137.96 Typical High $3,981.07 | Professional | None | $1,737.80 | $2,137.96 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,513.56 Typical High $2,137.96 | Professional | None | $151.36 | $1,513.56 | $2,137.96 |
SummaCare Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,737.80 | $1,905.46 | $3,311.31 |
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 $1,862.09 Median $2,344.23 Typical High $5,248.07 | Professional | None | $1,862.09 | $2,344.23 | $5,248.07 |
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 $977.24 Median $977.24 Typical High $3,235.94 | Professional | 52 · Reduced service | $977.24 | $977.24 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $1,288.25 | Professional | 53 · Discontinued | $389.05 | $389.05 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $977.24 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $645.65 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $4,570.88 |
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· 46th of 51
$1,738
AK $7,079TX $1,288
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.