How much rates vary
Facilitymedian $1,778 · 10th to 90th $617 to $9,120Professionalmedian $977 · 10th to 90th $661 to $1,514
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 $1,047.13 Median $10,715.19 Typical High $13,803.84 | Facility | None | $1,047.13 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $13,489.63 | Professional | None | $1,047.13 | $1,047.13 | $13,489.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $7,585.78 | Facility | None | $645.65 | $1,737.80 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,698.24 | Professional | None | $831.76 | $977.24 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $2,570.40 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $1,071.52 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $275.42 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,691.53 | Facility | None | $549.54 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,041.74 | Professional | None | $933.25 | $1,148.15 | $2,041.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,691.53 | Facility | None | $549.54 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,187.76 | Professional | None | $933.25 | $1,148.15 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $870.96 Typical High $1,148.15 | Professional | None | $70.79 | $870.96 | $1,148.15 |
SummaCare Setting Facility Modifier None Typical Low $831.76 Median $870.96 Typical High $1,000.00 | Facility | None | $831.76 | $870.96 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,698.24 | Professional | None | $891.25 | $977.24 | $1,698.24 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,818.38 | Professional | None | $977.24 | $1,288.25 | $2,818.38 |
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 $512.86 Median $512.86 Typical High $6,165.95 | Professional | 52 · Reduced service | $512.86 | $512.86 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $2,454.71 | Professional | 53 · Discontinued | $208.93 | $208.93 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $9,120.11 | Professional | 54 · Surgery only | $776.25 | $776.25 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $1,819.70 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $8,511.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $239.88 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $239.88 |
Where Ohio sits
The same service costs 4.7 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
$977
WI $3,890TX $832
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.