How much rates vary
Facilitymedian $1,202 · 10th to 90th $427 to $10,233Professionalmedian $363 · 10th to 90th $302 to $537
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 $416.87 Median $10,232.93 Typical High $13,803.84 | Facility | None | $416.87 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $1,258.93 | Professional | None | $354.81 | $354.81 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,659.59 Typical High $7,585.78 | Facility | None | $645.65 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $512.86 | Professional | None | $302.00 | $363.08 | $512.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $223.87 Typical High $331.13 | Professional | 62 · Two surgeons | $190.55 | $223.87 | $331.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $57.54 Typical High $83.18 | Professional | 80 · Assistant surgeon | $48.98 | $57.54 | $83.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $50.12 Typical High $72.44 | Professional | AS · PA/NP assist | $42.66 | $50.12 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $79,432.82 | Facility | None | $331.13 | $426.58 | $79,432.82 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | None | $363.08 | $363.08 | $407.38 |
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 $346.74 Median $363.08 Typical High $549.54 | Professional | None | $346.74 | $363.08 | $549.54 |
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 $346.74 Median $363.08 Typical High $549.54 | Professional | None | $346.74 | $363.08 | $549.54 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $218.78 | Professional | None | $117.49 | $169.82 | $218.78 |
SummaCare Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | None | $363.08 | $363.08 | $426.58 |
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 $269.15 Median $354.81 Typical High $537.03 | Professional | None | $269.15 | $354.81 | $537.03 |
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 $269.15 Median $269.15 Typical High $416.87 | Professional | 54 · Surgery only | $269.15 | $269.15 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $83.18 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $54.95 |
Where Ohio sits
The same service costs 15.1 times more in New York than in Hawaii. 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· 48th of 51
$363
NY $3,802HI $251
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.