How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $12,589Professionalmedian $1,230 · 10th to 90th $178 to $1,820
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 $1,348.96 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,348.96 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,348.96 | $2,691.53 |
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 $1,023.29 Median $1,202.26 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,202.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,096.48 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $288.40 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $245.47 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,412.54 | $1,621.81 |
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 $1,318.26 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,445.44 | $2,238.72 |
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 $1,318.26 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,445.44 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,096.48 Typical High $1,737.80 | Professional | None | $131.83 | $1,096.48 | $1,737.80 |
SummaCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,318.26 | $1,548.82 |
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 $1,096.48 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,412.54 | $2,187.76 |
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 $676.08 Median $676.08 Typical High $891.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,230.27 |
Where Ohio sits
The same service costs 5.4 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
$1,230
AK $4,677TX $871
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.