How much rates vary
Facilitymedian $1,862 · 10th to 90th $676 to $8,710Professionalmedian $603 · 10th to 90th $417 to $891
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 $2,089.30 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,089.30 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $9,120.11 | Professional | None | $588.84 | $588.84 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $4,786.30 | Facility | None | $630.96 | $1,230.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $933.25 | Professional | None | $457.09 | $575.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $363.08 Typical High $588.84 | Professional | 62 · Two surgeons | $288.40 | $363.08 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $91.20 Typical High $151.36 | Professional | 80 · Assistant surgeon | $72.44 | $91.20 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $79.43 Typical High $128.82 | Professional | AS · PA/NP assist | $63.10 | $79.43 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,089.30 | Facility | None | $741.31 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,819.70 Typical High $3,162.28 | Facility | None | $676.08 | $1,819.70 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,202.26 | Professional | None | $524.81 | $645.65 | $1,202.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $691.83 Median $1,819.70 Typical High $3,090.30 | Facility | None | $691.83 | $1,819.70 | $3,090.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,230.27 | Professional | None | $524.81 | $645.65 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $602.56 Typical High $812.83 | Professional | None | $57.54 | $602.56 | $812.83 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $831.76 | Professional | None | $562.34 | $562.34 | $831.76 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,445.44 | Professional | None | $562.34 | $691.83 | $1,445.44 |
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 $295.12 Median $295.12 Typical High $1,000.00 | Professional | 52 · Reduced service | $295.12 | $295.12 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $398.11 | Professional | 53 · Discontinued | $117.49 | $117.49 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $1,479.11 | Professional | 54 · Surgery only | $446.68 | $446.68 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $295.12 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $199.53 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $1,380.38 |
Where Ohio sits
The same service costs 5.4 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· 48th of 51
$631
AK $2,399UT $447
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.