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 $2,290.87 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,290.87 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $10,232.93 | Professional | None | $2,290.87 | $2,290.87 | $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 $1,905.46 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,238.72 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $354.81 Typical High $602.56 | Professional | 80 · Assistant surgeon | $302.00 | $354.81 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $309.03 Typical High $501.19 | Professional | AS · PA/NP assist | $263.03 | $309.03 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $2,041.74 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,570.40 | $4,677.35 |
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 $2,041.74 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,570.40 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,949.84 Typical High $2,570.40 | Professional | None | $186.21 | $1,949.84 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $3,801.89 | Professional | None | $1,995.26 | $2,187.76 | $3,801.89 |
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 $2,137.96 Median $2,884.03 Typical High $6,165.95 | Professional | None | $2,137.96 | $2,884.03 | $6,165.95 |
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 $1,737.80 Median $1,737.80 Typical High $5,128.61 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $5,128.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $4,786.30 |
Where Ohio sits
The same service costs 5.2 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· 44th of 51
$2,188
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.