How much rates vary
Facilitymedian $3,890 · 10th to 90th $550 to $12,589Professionalmedian $240 · 10th to 90th $195 to $355
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 $281.84 Median $10,232.93 Typical High $13,803.84 | Facility | None | $281.84 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $776.25 | Professional | None | $239.88 | $239.88 | $776.25 |
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 $204.17 Median $239.88 Typical High $338.84 | Professional | None | $204.17 | $239.88 | $338.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $128.82 Median $151.36 Typical High $213.80 | Professional | 62 · Two surgeons | $128.82 | $151.36 | $213.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $38.02 Typical High $56.23 | Professional | 80 · Assistant surgeon | $32.36 | $38.02 | $56.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $33.11 Typical High $48.98 | Professional | AS · PA/NP assist | $28.18 | $33.11 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | None | $257.04 | $257.04 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $436.52 | Professional | None | $239.88 | $263.03 | $436.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $436.52 | Professional | None | $239.88 | $263.03 | $436.52 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $316.23 | Professional | None | $165.96 | $213.80 | $316.23 |
SummaCare Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | None | $229.09 | $229.09 | $263.03 |
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 $204.17 Median $263.03 Typical High $398.11 | Professional | None | $204.17 | $263.03 | $398.11 |
5 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 $120.23 Median $120.23 Typical High $162.18 | Professional | 52 · Reduced service | $120.23 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $64.57 | Professional | 53 · Discontinued | $47.86 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $181.97 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $32.36 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $32.36 |
Where Ohio sits
The same service costs 5.0 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· 44th of 51
$245
AK $977UT $195
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.