How much rates vary
Facilitymedian $1,288 · 10th to 90th $447 to $10,233Professionalmedian $3,890 · 10th to 90th $389 to $5,623
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 $4,265.80 Median $10,715.19 Typical High $13,803.84 | Facility | None | $4,265.80 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $6,918.31 | Professional | None | $4,265.80 | $4,265.80 | $6,918.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $7,585.78 | Facility | None | $645.65 | $1,778.28 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $5,754.40 | Professional | None | $3,311.31 | $3,890.45 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,454.71 Typical High $3,630.78 | Professional | 62 · Two surgeons | $2,089.30 | $2,454.71 | $3,630.78 |
CareSource Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
CareSource Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,128.61 | Professional | None | $4,466.84 | $4,466.84 | $5,128.61 |
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 $4,073.80 Median $4,570.88 Typical High $6,918.31 | Professional | None | $4,073.80 | $4,570.88 | $6,918.31 |
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 $4,073.80 Median $4,570.88 Typical High $6,918.31 | Professional | None | $4,073.80 | $4,570.88 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $3,090.30 Typical High $5,248.07 | Professional | None | $354.81 | $3,090.30 | $5,248.07 |
SummaCare Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,786.30 | Professional | None | $4,073.80 | $4,073.80 | $4,786.30 |
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 $3,467.37 Median $4,466.84 Typical High $6,918.31 | Professional | None | $3,467.37 | $4,466.84 | $6,918.31 |
8 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 $2,137.96 Median $2,137.96 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | 53 · Discontinued | $851.14 | $851.14 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $4,168.69 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $831.76 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $630.96 Typical High $933.25 | Professional | 80 · Assistant surgeon | $537.03 | $630.96 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $549.54 Typical High $812.83 | Professional | AS · PA/NP assist | $467.74 | $549.54 | $812.83 |
Where Ohio sits
The same service costs 20.9 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· 46th of 51
$3,890
AK $14,125TX $676
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.