How much rates vary
Facilitymedian $1,820 · 10th to 90th $447 to $10,715Professionalmedian $1,660 · 10th to 90th $166 to $2,630
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 $1,905.46 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,905.46 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $9,332.54 | Professional | None | $1,905.46 | $1,905.46 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,398.83 Typical High $9,772.37 | Facility | None | $954.99 | $2,398.83 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,621.81 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,047.13 Typical High $1,698.24 | Professional | 62 · Two surgeons | $812.83 | $1,047.13 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $263.03 Typical High $446.68 | Professional | 80 · Assistant surgeon | $208.93 | $263.03 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $229.09 Typical High $380.19 | Professional | AS · PA/NP assist | $181.97 | $229.09 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,698.24 Median $2,089.30 Typical High $3,715.35 | Professional | None | $1,698.24 | $2,089.30 | $3,715.35 |
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 $1,698.24 Median $2,089.30 Typical High $3,715.35 | Professional | None | $1,698.24 | $2,089.30 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,445.44 Typical High $2,041.74 | Professional | None | $151.36 | $1,445.44 | $2,041.74 |
SummaCare Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,659.59 | $1,819.70 | $3,162.28 |
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 $1,737.80 Median $2,238.72 Typical High $5,128.61 | Professional | None | $1,737.80 | $2,238.72 | $5,128.61 |
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 $954.99 Median $954.99 Typical High $4,265.80 | Professional | 52 · Reduced service | $954.99 | $954.99 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $1,698.24 | Professional | 53 · Discontinued | $380.19 | $380.19 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $6,309.57 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $1,258.93 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $851.14 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $5,888.44 |
Where Ohio sits
The same service costs 5.9 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
$1,660
AK $6,918TX $1,175
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.