How much rates vary
Facilitymedian $1,778 · 10th to 90th $617 to $8,710Professionalmedian $1,000 · 10th to 90th $661 to $1,549
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 $1,071.52 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,071.52 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $10,232.93 | Professional | None | $1,071.52 | $1,071.52 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,584.89 | Professional | None | $831.76 | $1,023.29 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $645.65 Typical High $1,000.00 | Professional | 62 · Two surgeons | $524.81 | $645.65 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $165.96 Typical High $275.42 | Professional | 80 · Assistant surgeon | $131.83 | $165.96 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $144.54 Typical High $229.09 | Professional | AS · PA/NP assist | $114.82 | $144.54 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $954.99 Median $1,174.90 Typical High $2,290.87 | Professional | None | $954.99 | $1,174.90 | $2,290.87 |
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 $954.99 Median $1,174.90 Typical High $2,290.87 | Professional | None | $954.99 | $1,174.90 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $891.25 Typical High $1,174.90 | Professional | None | $70.79 | $891.25 | $1,174.90 |
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 $912.01 Median $1,000.00 Typical High $1,737.80 | Professional | None | $912.01 | $1,000.00 | $1,737.80 |
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 $1,000.00 Median $1,348.96 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,348.96 | $2,884.03 |
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 $537.03 Median $537.03 Typical High $1,621.81 | Professional | 52 · Reduced service | $537.03 | $537.03 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $645.65 | Professional | 53 · Discontinued | $213.80 | $213.80 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $2,454.71 | Professional | 54 · Surgery only | $794.33 | $794.33 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $489.78 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $323.59 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $2,290.87 |
Where Ohio sits
The same service costs 4.6 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· 48th of 51
$1,023
WI $3,981TX $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.