How much rates vary
Facilitymedian $1,820 · 10th to 90th $447 to $10,715Professionalmedian $2,042 · 10th to 90th $204 to $3,162
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 $2,398.83 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,398.83 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $10,232.93 | Professional | None | $2,398.83 | $2,398.83 | $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 $1,698.24 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,698.24 | $2,089.30 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,318.26 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,071.52 | $1,318.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $331.13 Typical High $549.54 | Professional | 80 · Assistant surgeon | $269.15 | $331.13 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $295.12 Typical High $478.63 | Professional | AS · PA/NP assist | $234.42 | $295.12 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $2,137.96 Median $2,691.53 Typical High $4,677.35 | Professional | None | $2,137.96 | $2,691.53 | $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 $2,137.96 Median $2,691.53 Typical High $4,677.35 | Professional | None | $2,137.96 | $2,691.53 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,778.28 Typical High $2,570.40 | Professional | None | $186.21 | $1,778.28 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $3,890.45 | Professional | None | $2,089.30 | $2,290.87 | $3,890.45 |
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 $6,456.54 | Professional | None | $2,238.72 | $2,818.38 | $6,456.54 |
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 $1,202.26 Median $1,202.26 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $1,412.54 | Professional | 53 · Discontinued | $478.63 | $478.63 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $5,248.07 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $1,047.13 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $707.95 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $4,897.79 |
Where Ohio sits
The same service costs 6.6 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
$1,995
AK $8,710TX $1,318
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.