How much rates vary
Facilitymedian $2,512 · 10th to 90th $692 to $10,715Professionalmedian $589 · 10th to 90th $417 to $912
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 $2,398.83 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,398.83 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $10,232.93 | Professional | None | $575.44 | $575.44 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $977.24 | Professional | None | $457.09 | $588.84 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $371.54 Typical High $616.60 | Professional | 62 · Two surgeons | $288.40 | $371.54 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $93.33 Typical High $162.18 | Professional | 80 · Assistant surgeon | $74.13 | $93.33 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $81.28 Typical High $138.04 | Professional | AS · PA/NP assist | $64.57 | $81.28 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $1,584.89 Typical High $2,398.83 | Facility | None | $724.44 | $1,584.89 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $3,801.89 | Facility | None | $549.54 | $2,398.83 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,174.90 | Professional | None | $524.81 | $630.96 | $1,174.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $3,715.35 | Facility | None | $549.54 | $2,398.83 | $3,715.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,202.26 | Professional | None | $512.86 | $630.96 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $575.44 Typical High $794.33 | Professional | None | $57.54 | $575.44 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,174.90 | $1,230.27 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $831.76 | Professional | None | $537.03 | $537.03 | $831.76 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,412.54 | Professional | None | $549.54 | $676.08 | $1,412.54 |
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 $288.40 Median $288.40 Typical High $707.95 | Professional | 52 · Reduced service | $288.40 | $288.40 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $288.40 | Professional | 53 · Discontinued | $117.49 | $117.49 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $436.52 | $436.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $213.80 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $1,000.00 |
Where Ohio sits
The same service costs 9.8 times more in Oklahoma 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· 49th of 51
$617
OK $4,365UT $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.