How much rates vary
Facilitymedian $1,862 · 10th to 90th $447 to $10,715Professionalmedian $2,089 · 10th to 90th $209 to $3,311
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 $2,344.23 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,344.23 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $10,232.93 | Professional | None | $2,344.23 | $2,344.23 | $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 $1,737.80 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,089.30 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,318.26 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,096.48 | $1,318.26 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $549.54 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $478.63 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $478.63 |
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 $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,089.30 | $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 $2,089.30 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,089.30 | $2,570.40 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,905.46 Typical High $2,570.40 | Professional | None | $186.21 | $1,905.46 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,238.72 | $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 $2,238.72 Median $2,818.38 Typical High $6,309.57 | Professional | None | $2,238.72 | $2,818.38 | $6,309.57 |
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 $1,174.90 Median $1,174.90 Typical High $3,388.44 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $1,348.96 | Professional | 53 · Discontinued | $467.74 | $467.74 | $1,348.96 |
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 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $1,023.29 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $676.08 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $676.08 |
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 5.4 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
$2,089
AK $8,318TX $1,549
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.