How much rates vary
Facilitymedian $1,820 · 10th to 90th $447 to $10,715Professionalmedian $2,239 · 10th to 90th $204 to $3,548
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 $2,511.89 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,511.89 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $9,332.54 | Professional | None | $2,511.89 | $2,511.89 | $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 $1,905.46 Median $2,344.23 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,344.23 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,479.11 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,202.26 | $1,479.11 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $371.54 Typical High $676.08 | Professional | 80 · Assistant surgeon | $302.00 | $371.54 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $323.59 Typical High $575.44 | Professional | AS · PA/NP assist | $263.03 | $323.59 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $2,238.72 Median $2,754.23 Typical High $4,897.79 | Professional | None | $2,238.72 | $2,754.23 | $4,897.79 |
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 $2,238.72 Median $2,754.23 Typical High $4,897.79 | Professional | None | $2,238.72 | $2,754.23 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,905.46 Typical High $2,691.53 | Professional | None | $186.21 | $1,905.46 | $2,691.53 |
SummaCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,398.83 | $4,168.69 |
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 $2,344.23 Median $2,951.21 Typical High $6,760.83 | Professional | None | $2,344.23 | $2,951.21 | $6,760.83 |
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 $1,258.93 Median $1,258.93 Typical High $3,467.37 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $1,380.38 | Professional | 53 · Discontinued | $501.19 | $501.19 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $5,248.07 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $1,047.13 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $691.83 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $4,897.79 |
Where Ohio sits
The same service costs 6.2 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
$2,239
AK $9,120TX $1,479
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.