How much rates vary
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 $6,606.93 Typical High $12,589.25 | Facility | None | $1,148.15 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $1,148.15 | Professional | None | $407.38 | $407.38 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $4,168.69 Typical High $26,915.35 | Facility | None | $1,995.26 | $4,168.69 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $549.54 | Professional | None | $331.13 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $208.93 Median $245.47 Typical High $354.81 | Professional | 62 · Two surgeons | $208.93 | $245.47 | $354.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $63.10 Typical High $91.20 | Professional | 80 · Assistant surgeon | $53.70 | $63.10 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $77.62 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | None | $436.52 | $436.52 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $707.95 | Professional | None | $398.11 | $446.68 | $707.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $707.95 | Professional | None | $407.38 | $446.68 | $707.95 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $363.08 Typical High $562.34 | Professional | None | $56.23 | $363.08 | $562.34 |
SummaCare Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | None | $398.11 | $398.11 | $467.74 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $7,244.36 Typical High $14,125.38 | Facility | None | $4,265.80 | $7,244.36 | $14,125.38 |
United Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $660.69 | Professional | None | $346.74 | $436.52 | $660.69 |
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 $309.03 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $309.03 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $380.19 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Where Ohio sits
The same service costs 4.4 times more in Alaska than in Utah. 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· 45th of 51
$398
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.