How much rates vary
Facilitymedian $3,236 · 10th to 90th $501 to $12,589Professionalmedian $1,122 · 10th to 90th $891 to $1,585
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 $2,041.74 Median $9,332.54 Typical High $12,589.25 | Facility | None | $2,041.74 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,148.15 | $2,454.71 |
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 $891.25 Median $1,071.52 Typical High $1,513.56 | Professional | None | $891.25 | $1,071.52 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $954.99 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $245.47 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $213.80 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
CareSource Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,148.15 | $1,318.26 |
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 $1,047.13 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,174.90 | $1,778.28 |
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 $1,047.13 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,174.90 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
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 $870.96 Median $1,122.02 Typical High $1,698.24 | Professional | None | $870.96 | $1,122.02 | $1,698.24 |
3 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 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $144.54 |
Where Ohio sits
The same service costs 5.6 times more in Alaska than in New York. 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
$1,122
AK $4,786NY $851
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.