How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $1,380 · 10th to 90th $178 to $2,042
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 $1,445.44 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,445.44 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,445.44 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $9,332.54 Typical High $21,877.62 | Facility | None | $1,047.13 | $9,332.54 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,380.38 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $870.96 Typical High $1,258.93 | Professional | 62 · Two surgeons | $741.31 | $870.96 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $323.59 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $194.98 Typical High $275.42 | Professional | AS · PA/NP assist | $162.18 | $194.98 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,513.56 | $1,737.80 |
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 $1,412.54 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,548.82 | $2,511.89 |
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 $1,412.54 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,548.82 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,230.27 Typical High $1,905.46 | Professional | None | $131.83 | $1,230.27 | $1,905.46 |
SummaCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,445.44 | $1,698.24 |
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 $1,174.90 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,548.82 | $2,344.23 |
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 $724.44 Median $724.44 Typical High $954.99 | Professional | 52 · Reduced service | $724.44 | $724.44 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | 53 · Discontinued | $288.40 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,348.96 |
Where Ohio sits
The same service costs 5.0 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· 44th of 51
$1,380
AK $5,012TX $1,000
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.