How much rates vary
Facilitymedian $794 · 10th to 90th $457 to $4,677Professionalmedian $562 · 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 $724.44 Median $10,232.93 Typical High $13,803.84 | Facility | None | $724.44 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,737.80 | Professional | None | $602.56 | $602.56 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $3,630.78 | Facility | None | $389.05 | $1,000.00 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $794.33 | Professional | None | $446.68 | $537.03 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $331.13 Typical High $501.19 | Professional | 62 · Two surgeons | $281.84 | $331.13 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $85.11 Typical High $128.82 | Professional | 80 · Assistant surgeon | $72.44 | $85.11 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $74.13 Typical High $109.65 | Professional | AS · PA/NP assist | $63.10 | $74.13 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $724.44 | Professional | None | $645.65 | $645.65 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $2,398.83 | Facility | None | $467.74 | $602.56 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $1,000.00 | Professional | None | $575.44 | $630.96 | $1,000.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $2,398.83 | Facility | None | $467.74 | $602.56 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $954.99 | Professional | None | $588.84 | $630.96 | $954.99 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $512.86 Typical High $794.33 | Professional | None | $64.57 | $512.86 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $257.04 Median $269.15 Typical High $309.03 | Facility | None | $257.04 | $269.15 | $309.03 |
SummaCare Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | None | $602.56 | $602.56 | $707.95 |
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 $489.78 Median $630.96 Typical High $977.24 | Professional | None | $489.78 | $630.96 | $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 $457.09 Median $457.09 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $457.09 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $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 $426.58 Median $426.58 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $562.34 |
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· 46th of 51
$562
AK $2,138TX $427
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.