How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $12,589Professionalmedian $1,072 · 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 $1,122.02 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,122.02 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,122.02 | $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 $912.01 Median $1,071.52 Typical High $1,548.82 | Professional | None | $912.01 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $676.08 Typical High $977.24 | Professional | 62 · Two surgeons | $575.44 | $676.08 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $245.47 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $218.78 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,202.26 | $1,348.96 |
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 $1,202.26 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,202.26 | $1,949.84 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,202.26 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $912.01 Typical High $1,445.44 | Professional | None | $97.72 | $912.01 | $1,445.44 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,096.48 | $1,288.25 |
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 $954.99 Median $1,202.26 Typical High $1,862.09 | Professional | None | $954.99 | $1,202.26 | $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 $562.34 Median $562.34 Typical High $741.31 | Professional | 52 · Reduced service | $562.34 | $562.34 | $741.31 |
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 $851.14 Median $851.14 Typical High $1,122.02 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $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
$1,072
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.