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 $9,332.54 | Professional | None | $1,949.84 | $1,949.84 | $9,332.54 |
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 $1,122.02 Typical High $1,905.46 | Professional | 62 · Two surgeons | $933.25 | $1,122.02 | $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 $208.93 Median $245.47 Typical High $426.58 | Professional | AS · PA/NP assist | $208.93 | $245.47 | $426.58 |
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 $1,737.80 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,137.96 | $4,168.69 |
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 $4,168.69 | Professional | None | $1,737.80 | $2,137.96 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,479.11 Typical High $2,089.30 | Professional | None | $151.36 | $1,479.11 | $2,089.30 |
SummaCare Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,698.24 | $1,862.09 | $3,235.94 |
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 $1,819.70 Median $2,290.87 Typical High $5,248.07 | Professional | None | $1,819.70 | $2,290.87 | $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 $954.99 Median $954.99 Typical High $3,090.30 | Professional | 52 · Reduced service | $954.99 | $954.99 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $1,230.27 | Professional | 53 · Discontinued | $389.05 | $389.05 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $933.25 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $616.60 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $4,265.80 |
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· 47th of 51
$1,738
AK $6,918TX $1,259
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.