How much rates vary
Facilitymedian $1,820 · 10th to 90th $447 to $10,965Professionalmedian $2,291 · 10th to 90th $204 to $3,715
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 $2,630.27 Median $10,715.19 Typical High $13,803.84 | Facility | None | $2,630.27 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $13,803.84 | Professional | None | $2,630.27 | $2,630.27 | $13,803.84 |
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 $1,949.84 Median $2,398.83 Typical High $4,265.80 | Professional | None | $1,949.84 | $2,398.83 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,513.56 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,230.27 | $1,513.56 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $389.05 Typical High $707.95 | Professional | 80 · Assistant surgeon | $309.03 | $389.05 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $331.13 Typical High $588.84 | Professional | AS · PA/NP assist | $269.15 | $331.13 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $2,344.23 Median $2,884.03 Typical High $5,128.61 | Professional | None | $2,344.23 | $2,884.03 | $5,128.61 |
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 $2,344.23 Median $2,884.03 Typical High $5,128.61 | Professional | None | $2,344.23 | $2,884.03 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,949.84 Typical High $2,818.38 | Professional | None | $186.21 | $1,949.84 | $2,818.38 |
SummaCare Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $4,265.80 | Professional | None | $2,238.72 | $2,454.71 | $4,265.80 |
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 $2,454.71 Median $3,090.30 Typical High $6,918.31 | Professional | None | $2,454.71 | $3,090.30 | $6,918.31 |
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 $1,288.25 Median $1,288.25 Typical High $7,762.47 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $7,762.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $3,090.30 | Professional | 53 · Discontinued | $524.81 | $524.81 | $3,090.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $11,481.54 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $11,481.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $2,290.87 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $2,290.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $1,548.82 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $10,715.19 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $10,715.19 |
Where Ohio sits
The same service costs 5.8 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
$2,291
AK $9,333TX $1,622
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.