How much rates vary
Facilitymedian $1,778 · 10th to 90th $617 to $8,710Professionalmedian $741 · 10th to 90th $81 to $1,122
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 $812.83 Median $812.83 Typical High $10,232.93 | Professional | None | $812.83 | $812.83 | $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 $389.05 Median $457.09 Typical High $1,000.00 | Professional | None | $389.05 | $457.09 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $72.44 Typical High $165.96 | Professional | 80 · Assistant surgeon | $61.66 | $72.44 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $64.57 Typical High $138.04 | Professional | AS · PA/NP assist | $53.70 | $64.57 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
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 $724.44 Median $794.33 Typical High $1,479.11 | Professional | None | $724.44 | $794.33 | $1,479.11 |
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 $724.44 Median $794.33 Typical High $1,479.11 | Professional | None | $724.44 | $794.33 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $741.31 Typical High $1,023.29 | Professional | None | $70.79 | $741.31 | $1,023.29 |
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 $758.58 Median $794.33 Typical High $1,445.44 | Professional | None | $758.58 | $794.33 | $1,445.44 |
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 $588.84 Median $851.14 Typical High $2,187.76 | Professional | None | $588.84 | $851.14 | $2,187.76 |
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 $407.38 Median $407.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $549.54 | Professional | 53 · Discontinued | $165.96 | $165.96 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $2,089.30 | Professional | 54 · Surgery only | $616.60 | $616.60 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $416.87 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $275.42 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,949.84 |
Where Ohio sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. 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
$776
OK $4,169KY $617
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.