How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $12,589Professionalmedian $1,622 · 10th to 90th $219 to $2,291
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 $1,698.24 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,698.24 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,698.24 | $1,698.24 | $2,754.23 |
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 $1,380.38 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,621.81 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,023.29 Typical High $1,445.44 | Professional | 62 · Two surgeons | $851.14 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $257.04 Typical High $371.54 | Professional | 80 · Assistant surgeon | $218.78 | $257.04 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $323.59 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,819.70 | $1,819.70 | $2,041.74 |
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 $1,621.81 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,819.70 | $2,884.03 |
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 $1,621.81 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,819.70 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,348.96 Typical High $2,137.96 | Professional | None | $165.96 | $1,348.96 | $2,137.96 |
SummaCare Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,621.81 | $1,905.46 |
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 $1,412.54 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,819.70 | $2,754.23 |
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 $851.14 Median $851.14 Typical High $1,122.02 | Professional | 52 · Reduced service | $851.14 | $851.14 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | 53 · Discontinued | $338.84 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $338.84 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,584.89 |
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
$1,622
AK $5,888TX $1,096
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.