How much rates vary
Facilitymedian $4,266 · 10th to 90th $501 to $12,589Professionalmedian $1,660 · 10th to 90th $219 to $2,455
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 $1,819.70 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,819.70 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,819.70 | $1,819.70 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,760.83 Typical High $14,125.38 | Facility | None | $891.25 | $6,760.83 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,659.59 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,047.13 Typical High $1,513.56 | Professional | 62 · Two surgeons | $891.25 | $1,047.13 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $389.05 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $229.09 Typical High $338.84 | Professional | AS · PA/NP assist | $194.98 | $229.09 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,905.46 | $1,905.46 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $4,786.30 | Facility | None | $426.58 | $588.84 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,737.80 | $1,949.84 | $3,019.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $4,786.30 | Facility | None | $426.58 | $602.56 | $4,786.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,737.80 | $1,949.84 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,479.11 Typical High $2,290.87 | Professional | None | $165.96 | $1,479.11 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
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 $1,479.11 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,905.46 | $2,951.21 |
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 $891.25 Median $891.25 Typical High $1,174.90 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $467.74 | Professional | 53 · Discontinued | $363.08 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,659.59 |
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· 47th of 51
$1,660
AK $6,310TX $1,175
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.