How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $12,589Professionalmedian $1,047 · 10th to 90th $135 to $1,549
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 $1,148.15 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,148.15 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,148.15 | $2,454.71 |
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 $851.14 Median $1,000.00 Typical High $1,513.56 | Professional | None | $851.14 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $630.96 Typical High $954.99 | Professional | 62 · Two surgeons | $537.03 | $630.96 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $239.88 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $208.93 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,202.26 | $1,380.38 |
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 $1,096.48 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,230.27 | $1,905.46 |
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 $1,122.02 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,230.27 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $933.25 Typical High $1,479.11 | Professional | None | $97.72 | $933.25 | $1,479.11 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
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 $933.25 Median $1,230.27 Typical High $1,862.09 | Professional | None | $933.25 | $1,230.27 | $1,862.09 |
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 $575.44 Median $575.44 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,122.02 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,047.13 |
Where Ohio sits
The same service costs 5.6 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· 47th of 51
$1,047
AK $4,266TX $759
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.