How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $12,589Professionalmedian $1,820 · 10th to 90th $794 to $2,692
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 $2,041.74 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,041.74 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,041.74 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,803.84 | Facility | None | $891.25 | $6,606.93 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,230.27 | Professional | None | $724.44 | $851.14 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $537.03 Typical High $776.25 | Professional | 62 · Two surgeons | $446.68 | $537.03 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $199.53 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $173.78 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $79,432.82 | Facility | None | $1,862.09 | $2,398.83 | $79,432.82 |
CareSource Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,344.23 | Professional | None | $2,041.74 | $2,041.74 | $2,344.23 |
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 $1,905.46 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,041.74 | $3,162.28 |
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 $1,905.46 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,041.74 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,445.44 | $1,698.24 |
SummaCare Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,454.71 | $2,884.03 |
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 $1,737.80 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,344.23 | $3,548.13 |
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 $1,023.29 Median $1,023.29 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $645.65 | Professional | 53 · Discontinued | $407.38 | $407.38 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $323.59 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $2,238.72 |
Where Ohio sits
The same service costs 9.8 times more in Alaska 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· 46th of 51
$1,905
AK $8,511KY $871
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.