How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $12,589Professionalmedian $1,202 · 10th to 90th $178 to $1,778
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 $1,318.26 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,318.26 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,318.26 | $2,630.27 |
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 $1,000.00 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $1,096.48 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $275.42 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $239.88 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,380.38 | $1,548.82 |
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 $1,258.93 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,412.54 | $2,187.76 |
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 $1,258.93 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,412.54 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,047.13 Typical High $1,659.59 | Professional | None | $131.83 | $1,047.13 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
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 $1,071.52 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,380.38 | $2,089.30 |
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 $660.69 Median $660.69 Typical High $851.14 | Professional | 52 · Reduced service | $660.69 | $660.69 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | 53 · Discontinued | $263.03 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $257.04 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,202.26 |
Where Ohio sits
The same service costs 5.4 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
$1,202
AK $4,571TX $851
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.