How much rates vary
Facilitymedian $4,365 · 10th to 90th $501 to $13,490Professionalmedian $1,122 · 10th to 90th $138 to $1,660
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 $3,548.13 Median $10,232.93 Typical High $19,498.45 | Facility | None | $3,548.13 | $10,232.93 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $10,964.78 | Professional | None | $1,148.15 | $1,148.15 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,489.63 | Facility | None | $891.25 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,778.28 | Professional | None | $891.25 | $1,096.48 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $691.83 Typical High $1,122.02 | Professional | 62 · Two surgeons | $562.34 | $691.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $295.12 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $295.12 |
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 |
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 $1,000.00 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,258.93 | $2,344.23 |
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 $1,000.00 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,258.93 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,047.13 Typical High $1,513.56 | Professional | None | $123.03 | $1,047.13 | $1,513.56 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,047.13 | $1,621.81 |
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 $1,071.52 Median $1,318.26 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,318.26 | $2,754.23 |
7 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 $2,137.96 | Professional | 52 · Reduced service | $562.34 | $562.34 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $870.96 | Professional | 53 · Discontinued | $229.09 | $229.09 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $3,235.94 | Professional | 54 · Surgery only | $851.14 | $851.14 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $645.65 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $436.52 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $3,019.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $151.36 Typical High $251.19 | Professional | AS · PA/NP assist | $125.89 | $151.36 | $251.19 |
Where Ohio sits
The same service costs 5.8 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· 46th of 51
$1,148
AK $4,571UT $794
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.