How much rates vary
Facilitymedian $1,950 · 10th to 90th $447 to $10,233Professionalmedian $1,318 · 10th to 90th $123 to $2,042
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 $3,715.35 Median $4,897.79 Typical High $12,589.25 | Facility | None | $3,715.35 | $4,897.79 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $10,232.93 | Professional | None | $1,479.11 | $1,479.11 | $10,232.93 |
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 $1,148.15 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,348.96 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $851.14 Typical High $1,479.11 | Professional | 62 · Two surgeons | $724.44 | $851.14 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $223.87 Typical High $398.11 | Professional | 80 · Assistant surgeon | $181.97 | $223.87 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $194.98 Typical High $331.13 | Professional | AS · PA/NP assist | $158.49 | $194.98 | $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 $1,318.26 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,621.81 | $2,951.21 |
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 $1,318.26 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,621.81 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,096.48 Typical High $1,584.89 | Professional | None | $114.82 | $1,096.48 | $1,584.89 |
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 $1,778.28 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,778.28 | $3,981.07 |
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 $741.31 Median $741.31 Typical High $2,137.96 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $851.14 | Professional | 53 · Discontinued | $295.12 | $295.12 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $630.96 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $426.58 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $2,951.21 |
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· 48th of 51
$1,318
AK $5,370TX $912
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.