How much rates vary
Facilitymedian $2,884 · 10th to 90th $708 to $10,233Professionalmedian $1,072 · 10th to 90th $692 to $1,660
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 $1,122.02 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,122.02 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $10,232.93 | Professional | None | $1,122.02 | $1,122.02 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,737.80 | Professional | None | $933.25 | $1,096.48 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,659.59 Typical High $2,570.40 | Professional | 50 · Both sides | $1,412.54 | $1,659.59 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $1,071.52 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $295.12 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,019.95 Typical High $5,248.07 | Facility | None | $549.54 | $3,019.95 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,258.93 | $2,511.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,019.95 Typical High $5,128.61 | Facility | None | $549.54 | $3,019.95 | $5,128.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,258.93 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $933.25 Typical High $1,258.93 | Professional | None | $70.79 | $933.25 | $1,258.93 |
SummaCare Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,949.84 | Facility | None | $1,659.59 | $1,737.80 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,862.09 | Professional | None | $977.24 | $1,071.52 | $1,862.09 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,445.44 | $3,019.95 |
7 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 $562.34 Median $562.34 Typical High $1,819.70 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $724.44 | Professional | 53 · Discontinued | $223.87 | $223.87 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $2,754.23 | Professional | 54 · Surgery only | $851.14 | $851.14 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $549.54 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $363.08 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $2,570.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $245.47 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $245.47 |
Where Ohio sits
The same service costs 5.1 times more in Wisconsin 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· 49th of 51
$1,096
WI $4,677TX $912
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.