How much rates vary
Facilitymedian $813 · 10th to 90th $389 to $4,169Professionalmedian $813 · 10th to 90th $603 to $1,288
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $10,232.93 | Professional | None | $870.96 | $870.96 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $3,715.35 | Facility | None | $389.05 | $1,000.00 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $794.33 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $204.17 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $177.83 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $2,398.83 | Facility | None | $537.03 | $724.44 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $2,041.74 | Professional | None | $776.25 | $1,071.52 | $2,041.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $2,398.83 | Facility | None | $537.03 | $724.44 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $2,041.74 | Professional | None | $776.25 | $1,071.52 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,000.00 | Professional | None | $501.19 | $758.58 | $1,000.00 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $398.11 | Facility | None | $338.84 | $354.81 | $398.11 |
SummaCare Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,513.56 | Professional | None | $741.31 | $812.83 | $1,513.56 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $2,344.23 | Professional | None | $870.96 | $1,122.02 | $2,344.23 |
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 $436.52 Median $436.52 Typical High $1,445.44 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $575.44 | Professional | 53 · Discontinued | $173.78 | $173.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $2,137.96 | Professional | 54 · Surgery only | $645.65 | $645.65 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $426.58 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $288.40 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,995.26 |
Where Ohio sits
The same service costs 4.4 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· 50th of 51
$813
AK $3,020TX $692
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.