How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $10,965Professionalmedian $1,380 · 10th to 90th $178 to $2,089
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 $1,513.56 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,513.56 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,513.56 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,623.41 Typical High $10,964.78 | Facility | None | $891.25 | $5,623.41 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,318.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $831.76 Typical High $1,258.93 | Professional | 62 · Two surgeons | $707.95 | $831.76 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $323.59 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $269.15 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
CareSource Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,621.81 | $1,621.81 | $1,819.70 |
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 $1,445.44 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,621.81 | $2,454.71 |
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 $1,445.44 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,621.81 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,258.93 Typical High $1,995.26 | Professional | None | $131.83 | $1,258.93 | $1,995.26 |
SummaCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
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 $1,230.27 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,621.81 | $2,454.71 |
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 $758.58 Median $758.58 Typical High $1,000.00 | Professional | 52 · Reduced service | $758.58 | $758.58 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | 53 · Discontinued | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,412.54 |
Where Ohio sits
The same service costs 5.1 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· 46th of 51
$1,413
AK $5,129TX $1,000
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.