How much rates vary
Facilitymedian $1,585 · 10th to 90th $447 to $10,715Professionalmedian $1,349 · 10th to 90th $123 to $2,138
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 $1,445.44 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,445.44 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $9,332.54 | Professional | None | $1,445.44 | $1,445.44 | $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 $1,023.29 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,288.25 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,479.11 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $204.17 Typical High $371.54 | Professional | 80 · Assistant surgeon | $165.96 | $204.17 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $331.13 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,288.25 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,584.89 | $2,818.38 |
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 $1,288.25 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,584.89 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $1,230.27 Typical High $1,659.59 | Professional | None | $107.15 | $1,230.27 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,412.54 | $2,454.71 |
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 $1,380.38 Median $1,737.80 Typical High $3,890.45 | Professional | None | $1,380.38 | $1,737.80 | $3,890.45 |
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 $724.44 Median $724.44 Typical High $2,290.87 | Professional | 52 · Reduced service | $724.44 | $724.44 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $933.25 | Professional | 53 · Discontinued | $288.40 | $288.40 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $691.83 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $467.74 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $3,235.94 |
Where Ohio sits
The same service costs 5.0 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
$1,349
AK $5,248TX $1,047
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.