How much rates vary
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 $2,238.72 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,238.72 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $10,232.93 | Professional | None | $2,238.72 | $2,238.72 | $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 $1,819.70 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,137.96 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,348.96 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,148.15 | $1,348.96 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $575.44 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $302.00 Typical High $478.63 | Professional | AS · PA/NP assist | $257.04 | $302.00 | $478.63 |
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 $1,995.26 Median $2,454.71 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,454.71 | $4,466.84 |
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 $1,995.26 Median $2,454.71 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,454.71 | $4,466.84 |
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 $2,089.30 Median $2,754.23 Typical High $6,025.60 | Professional | None | $2,089.30 | $2,754.23 | $6,025.60 |
2 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 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $4,897.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $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· 45th of 51
$2,089
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.