How much rates vary
Facilitymedian $2,884 · 10th to 90th $759 to $9,120Professionalmedian $741 · 10th to 90th $417 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 $8,128.31 Typical High $13,803.84 | Facility | None | $1,000.00 | $8,128.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $912.01 | Professional | None | $660.69 | $851.14 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $7,762.47 | Facility | None | $724.44 | $2,187.76 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,047.13 | Professional | None | $489.78 | $676.08 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $109.65 Typical High $165.96 | Professional | 80 · Assistant surgeon | $79.43 | $109.65 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $95.50 Typical High $144.54 | Professional | AS · PA/NP assist | $69.18 | $95.50 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $2,818.38 Typical High $3,630.78 | Facility | None | $831.76 | $2,818.38 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | None | $707.95 | $707.95 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,951.21 Typical High $4,897.79 | Facility | None | $741.31 | $2,951.21 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,258.93 | Professional | None | $660.69 | $831.76 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $4,570.88 | Facility | None | $741.31 | $3,019.95 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,258.93 | Professional | None | $660.69 | $831.76 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $707.95 Typical High $1,148.15 | Professional | None | $64.57 | $707.95 | $1,148.15 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,000.00 | Professional | None | $602.56 | $812.83 | $1,000.00 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Professional | None | $588.84 | $812.83 | $1,202.26 |
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 $331.13 Median $416.87 Typical High $426.58 | Professional | 52 · Reduced service | $331.13 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $131.83 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $630.96 Typical High $645.65 | Professional | 54 · Surgery only | $501.19 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $588.84 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $467.74 | $588.84 | $602.56 |
Where Ohio sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$741
AK $2,754NJ $631
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.