How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $12,589Professionalmedian $1,259 · 10th to 90th $178 to $1,905
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 $1,412.54 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,412.54 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $4,786.30 | Professional | None | $1,412.54 | $1,412.54 | $4,786.30 |
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 $1,023.29 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $794.33 Typical High $1,148.15 | Professional | 62 · Two surgeons | $645.65 | $794.33 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $288.40 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $257.04 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,479.11 | $1,698.24 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,513.56 | $2,344.23 |
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 $1,348.96 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,513.56 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,148.15 Typical High $1,778.28 | Professional | None | $131.83 | $1,148.15 | $1,778.28 |
SummaCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,348.96 | $1,584.89 |
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 $1,148.15 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,479.11 | $2,290.87 |
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 $707.95 Median $707.95 Typical High $933.25 | Professional | 52 · Reduced service | $707.95 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $371.54 | Professional | 53 · Discontinued | $281.84 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,288.25 |
Where Ohio sits
The same service costs 5.2 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
$1,288
AK $4,898TX $933
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.