How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $12,589Professionalmedian $1,202 · 10th to 90th $85 to $1,950
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 $1,380.38 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,380.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $9,332.54 | Professional | None | $1,380.38 | $1,380.38 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,258.93 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $794.33 Typical High $1,288.25 | Professional | 62 · Two surgeons | $630.96 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $346.74 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $288.40 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,202.26 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,513.56 | $2,818.38 |
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 $1,202.26 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,513.56 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $1,047.13 Typical High $1,513.56 | Professional | None | $77.62 | $1,047.13 | $1,513.56 |
SummaCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,318.26 | $2,290.87 |
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 $1,288.25 Median $1,621.81 Typical High $3,630.78 | Professional | None | $1,288.25 | $1,621.81 | $3,630.78 |
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 $676.08 Median $676.08 Typical High $3,090.30 | Professional | 52 · Reduced service | $676.08 | $676.08 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,258.93 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $933.25 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $630.96 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $4,365.16 |
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· 48th of 51
$1,202
AK $5,012TX $933
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.