How much rates vary
Facilitymedian $2,884 · 10th to 90th $708 to $10,233Professionalmedian $1,047 · 10th to 90th $661 to $1,585
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 $1,096.48 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,096.48 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $10,232.93 | Professional | None | $1,096.48 | $1,096.48 | $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 $891.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $891.25 | $1,071.52 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $2,454.71 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $1,047.13 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $281.84 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $977.24 Median $1,202.26 Typical High $2,344.23 | Professional | None | $977.24 | $1,202.26 | $2,344.23 |
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 $977.24 Median $1,202.26 Typical High $2,344.23 | Professional | None | $977.24 | $1,202.26 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $933.25 Typical High $1,230.27 | Professional | None | $70.79 | $933.25 | $1,230.27 |
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 $933.25 Median $1,023.29 Typical High $1,778.28 | Professional | None | $933.25 | $1,023.29 | $1,778.28 |
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 $1,047.13 Median $1,348.96 Typical High $2,951.21 | Professional | None | $1,047.13 | $1,348.96 | $2,951.21 |
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 $549.54 Median $549.54 Typical High $1,584.89 | Professional | 52 · Reduced service | $549.54 | $549.54 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $630.96 | Professional | 53 · Discontinued | $218.78 | $218.78 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $2,344.23 | Professional | 54 · Surgery only | $812.83 | $812.83 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $467.74 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $316.23 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $2,187.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $234.42 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $234.42 |
Where Ohio sits
The same service costs 5.0 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
$1,072
WI $4,365TX $871
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.