How much rates vary
Facilitymedian $1,862 · 10th to 90th $741 to $9,120Professionalmedian $603 · 10th to 90th $91 to $832
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 $2,238.72 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,238.72 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $2,238.72 | Professional | None | $602.56 | $602.56 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $4,897.79 | Facility | None | $645.65 | $1,348.96 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $912.01 | Professional | None | $537.03 | $630.96 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $398.11 Typical High $575.44 | Professional | 62 · Two surgeons | $338.84 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $100.00 Typical High $147.91 | Professional | 80 · Assistant surgeon | $85.11 | $100.00 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $87.10 Typical High $125.89 | Professional | AS · PA/NP assist | $74.13 | $87.10 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,348.96 Typical High $1,737.80 | Facility | None | $741.31 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,951.21 | Facility | None | $741.31 | $1,584.89 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $1,122.02 | Professional | None | $575.44 | $616.60 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,951.21 | Facility | None | $741.31 | $1,584.89 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,122.02 | Professional | None | $562.34 | $616.60 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $446.68 Typical High $724.44 | Professional | None | $64.57 | $446.68 | $724.44 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | None | $549.54 | $549.54 | $630.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $977.24 | Professional | None | $501.19 | $645.65 | $977.24 |
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 $302.00 Median $302.00 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $602.56 | Professional | 54 · Surgery only | $446.68 | $446.68 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $120.23 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $562.34 |
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
$603
AK $2,455TX $380
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.