How much rates vary
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 $2,570.40 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,570.40 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $10,232.93 | Professional | None | $2,570.40 | $2,570.40 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $6,025.60 Typical High $12,589.25 | Facility | None | $1,071.52 | $6,025.60 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,398.83 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,513.56 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,288.25 | $1,513.56 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $380.19 Typical High $645.65 | Professional | 80 · Assistant surgeon | $323.59 | $380.19 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $338.84 Typical High $537.03 | Professional | AS · PA/NP assist | $281.84 | $338.84 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $2,290.87 Median $2,884.03 Typical High $5,754.40 | Professional | None | $2,290.87 | $2,884.03 | $5,754.40 |
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 $2,290.87 Median $2,884.03 Typical High $5,754.40 | Professional | None | $2,290.87 | $2,884.03 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,949.84 Typical High $2,754.23 | Professional | None | $158.49 | $1,949.84 | $2,754.23 |
SummaCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $4,265.80 | Professional | None | $2,187.76 | $2,398.83 | $4,265.80 |
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 $2,454.71 Median $3,162.28 Typical High $6,918.31 | Professional | None | $2,454.71 | $3,162.28 | $6,918.31 |
2 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 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $5,495.41 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $5,495.41 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $5,128.61 |
Where Ohio sits
The same service costs 6.5 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· 46th of 51
$2,344
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.