How much rates vary
Facilitymedian $4,365 · 10th to 90th $501 to $12,589Professionalmedian $1,380 · 10th to 90th $178 to $1,995
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $5,011.87 | Professional | None | $1,479.11 | $1,479.11 | $5,011.87 |
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 $1,174.90 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,380.38 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $870.96 Typical High $1,258.93 | Professional | 62 · Two surgeons | $741.31 | $870.96 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $316.23 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $275.42 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,548.82 | $1,548.82 | $1,778.28 |
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 $1,412.54 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,584.89 | $2,511.89 |
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 $1,412.54 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,584.89 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,202.26 Typical High $1,905.46 | Professional | None | $131.83 | $1,202.26 | $1,905.46 |
SummaCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
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 $1,584.89 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,584.89 | $2,398.83 |
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 $741.31 Median $741.31 Typical High $977.24 | Professional | 52 · Reduced service | $741.31 | $741.31 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $389.05 | Professional | 53 · Discontinued | $295.12 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $288.40 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,348.96 |
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· 46th of 51
$1,380
AK $5,129TX $977
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.