How much rates vary
Facilitymedian $1,514 · 10th to 90th $490 to $6,607Professionalmedian $1,698 · 10th to 90th $166 to $2,570
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 $1,995.26 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,995.26 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $10,232.93 | Professional | None | $1,995.26 | $1,995.26 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $3,801.89 | Facility | None | $794.33 | $1,584.89 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,698.24 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,071.52 Typical High $1,737.80 | Professional | 62 · Two surgeons | $870.96 | $1,071.52 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $436.52 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $1,737.80 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,187.76 | $3,890.45 |
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 $1,737.80 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,187.76 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,513.56 Typical High $2,137.96 | Professional | None | $151.36 | $1,513.56 | $2,137.96 |
SummaCare Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,737.80 | $1,905.46 | $3,311.31 |
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 $1,819.70 Median $2,344.23 Typical High $5,248.07 | Professional | None | $1,819.70 | $2,344.23 | $5,248.07 |
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 $977.24 Median $977.24 Typical High $3,388.44 | Professional | 52 · Reduced service | $977.24 | $977.24 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $1,348.96 | Professional | 53 · Discontinued | $398.11 | $398.11 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $5,128.61 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $1,023.29 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $676.08 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $4,786.30 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $239.88 Typical High $380.19 | Professional | AS · PA/NP assist | $190.55 | $239.88 | $380.19 |
Where Ohio sits
The same service costs 5.8 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· 45th of 51
$1,698
AK $7,079TX $1,230
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.