How much rates vary
Facilitymedian $1,862 · 10th to 90th $447 to $12,589Professionalmedian $1,950 · 10th to 90th $166 to $3,020
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 $2,187.76 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,187.76 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $10,232.93 | Professional | None | $2,187.76 | $2,187.76 | $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 $1,698.24 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,041.74 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,288.25 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,071.52 | $1,288.25 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $331.13 Typical High $562.34 | Professional | 80 · Assistant surgeon | $269.15 | $331.13 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $288.40 Typical High $489.78 | Professional | AS · PA/NP assist | $239.88 | $288.40 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,949.84 Median $2,454.71 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,454.71 | $4,365.16 |
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 $1,949.84 Median $2,454.71 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,454.71 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,659.59 Typical High $2,344.23 | Professional | None | $151.36 | $1,659.59 | $2,344.23 |
SummaCare Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,905.46 | $2,089.30 | $3,630.78 |
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 $2,630.27 Typical High $5,888.44 | Professional | None | $2,089.30 | $2,630.27 | $5,888.44 |
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 $1,096.48 Median $1,096.48 Typical High $3,467.37 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $1,412.54 | Professional | 53 · Discontinued | $436.52 | $436.52 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $5,248.07 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $707.95 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $4,897.79 |
Where Ohio sits
The same service costs 5.8 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
$1,950
AK $7,943TX $1,380
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.