How much rates vary
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 $1,202.26 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,202.26 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $1,174.90 | Professional | None | $331.13 | $331.13 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,677.35 | Facility | None | $524.81 | $1,148.15 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $436.52 | Professional | None | $245.47 | $288.40 | $436.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $154.88 Median $181.97 Typical High $275.42 | Professional | 62 · Two surgeons | $154.88 | $181.97 | $275.42 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $45.71 Typical High $70.79 | Professional | 80 · Assistant surgeon | $38.90 | $45.71 | $70.79 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $39.81 Typical High $61.66 | Professional | AS · PA/NP assist | $33.88 | $39.81 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $954.99 Typical High $1,230.27 | Facility | None | $416.87 | $954.99 | $1,230.27 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | None | $346.74 | $346.74 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $1,862.09 | Facility | None | $398.11 | $1,202.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $549.54 | Professional | None | $323.59 | $346.74 | $549.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $1,819.70 | Facility | None | $398.11 | $1,202.26 | $1,819.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $537.03 | Professional | None | $323.59 | $346.74 | $537.03 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $478.63 | Professional | None | $239.88 | $316.23 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,380.38 | Facility | None | $1,174.90 | $1,230.27 | $1,380.38 |
SummaCare Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | None | $338.84 | $338.84 | $398.11 |
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 $263.03 Median $346.74 Typical High $524.81 | Professional | None | $263.03 | $346.74 | $524.81 |
1 more rate 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 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $302.00 |
Where Ohio sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 42nd of 51
$331
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.