How much rates vary
Facilitymedian $891 · 10th to 90th $437 to $5,248Professionalmedian $537 · 10th to 90th $91 to $794
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 $676.08 Median $10,232.93 Typical High $13,803.84 | Facility | None | $676.08 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,621.81 | Professional | None | $562.34 | $562.34 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $794.33 | Professional | None | $457.09 | $537.03 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $338.84 Typical High $512.86 | Professional | 62 · Two surgeons | $288.40 | $338.84 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $87.10 Typical High $128.82 | Professional | 80 · Assistant surgeon | $74.13 | $87.10 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $75.86 Typical High $112.20 | Professional | AS · PA/NP assist | $64.57 | $75.86 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | None | $602.56 | $602.56 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $1,479.11 | Facility | None | $398.11 | $707.95 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $954.99 | Professional | None | $562.34 | $588.84 | $954.99 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $1,479.11 | Facility | None | $398.11 | $707.95 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $954.99 | Professional | None | $562.34 | $588.84 | $954.99 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $467.74 Typical High $741.31 | Professional | None | $64.57 | $467.74 | $741.31 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $912.01 | Professional | None | $457.09 | $588.84 | $912.01 |
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 $281.84 Median $281.84 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $512.86 |
Where Ohio sits
The same service costs 5.5 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
$537
AK $2,188TX $398
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.