How much rates vary
Facilitymedian $5,248 · 10th to 90th $513 to $19,055Professionalmedian $741 · 10th to 90th $91 to $1,096
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 $3,467.37 Median $10,000.00 Typical High $13,803.84 | Facility | None | $3,467.37 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $3,467.37 | Professional | None | $776.25 | $776.25 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $9,549.93 Typical High $22,908.68 | Facility | None | $1,148.15 | $9,549.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,174.90 | Professional | None | $630.96 | $741.31 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $467.74 Typical High $741.31 | Professional | 62 · Two surgeons | $398.11 | $467.74 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $190.55 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $162.18 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | None | $812.83 | $812.83 | $933.25 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,318.26 | Professional | None | $758.58 | $831.76 | $1,318.26 |
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 $758.58 Median $831.76 Typical High $1,318.26 | Professional | None | $758.58 | $831.76 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $645.65 Typical High $1,000.00 | Professional | None | $64.57 | $645.65 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | None | $758.58 | $758.58 | $891.25 |
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 $645.65 Median $812.83 Typical High $1,258.93 | Professional | None | $645.65 | $812.83 | $1,258.93 |
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 $389.05 Median $389.05 Typical High $512.86 | Professional | 52 · Reduced service | $389.05 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $707.95 |
Where Ohio sits
The same service costs 5.9 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
$741
AK $3,162TX $537
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.