How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $12,589Professionalmedian $933 · 10th to 90th $91 to $1,413
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,000.00 | $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 $741.31 Median $870.96 Typical High $1,318.26 | Professional | None | $741.31 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $549.54 Typical High $831.76 | Professional | 62 · Two surgeons | $467.74 | $549.54 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $213.80 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $186.21 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,047.13 | $1,174.90 |
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 $954.99 Median $1,047.13 Typical High $1,621.81 | Professional | None | $954.99 | $1,047.13 | $1,621.81 |
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 $954.99 Median $1,047.13 Typical High $1,584.89 | Professional | None | $954.99 | $1,047.13 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $851.14 Typical High $1,348.96 | Professional | None | $64.57 | $851.14 | $1,348.96 |
SummaCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,000.00 | $1,174.90 |
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 $812.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $812.83 | $1,047.13 | $1,621.81 |
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 $489.78 Median $489.78 Typical High $660.69 | Professional | 52 · Reduced service | $489.78 | $489.78 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | 54 · Surgery only | $741.31 | $741.31 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $912.01 |
Where Ohio sits
The same service costs 4.9 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
$955
AK $3,548TX $724
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.