How much rates vary
Facilitymedian $2,570 · 10th to 90th $617 to $8,318Professionalmedian $871 · 10th to 90th $91 to $1,318
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 $2,344.23 Median $3,548.13 Typical High $12,022.64 | Facility | None | $2,344.23 | $3,548.13 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $4,570.88 | Professional | None | $870.96 | $870.96 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,348.96 | Professional | None | $676.08 | $831.76 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $524.81 Typical High $851.14 | Professional | 62 · Two surgeons | $426.58 | $524.81 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $131.83 Typical High $218.78 | Professional | 80 · Assistant surgeon | $109.65 | $131.83 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $3,162.28 | Facility | None | $1,071.52 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,570.40 Typical High $4,168.69 | Facility | None | $489.78 | $2,570.40 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,778.28 | Professional | None | $776.25 | $954.99 | $1,778.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,570.40 Typical High $4,073.80 | Facility | None | $512.86 | $2,570.40 | $4,073.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,778.28 | Professional | None | $776.25 | $954.99 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $831.76 Typical High $1,174.90 | Professional | None | $79.43 | $831.76 | $1,174.90 |
SummaCare Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,412.54 | $1,479.11 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,258.93 | Professional | None | $812.83 | $812.83 | $1,258.93 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $2,089.30 | Professional | None | $831.76 | $1,023.29 | $2,089.30 |
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 $436.52 Median $436.52 Typical High $1,445.44 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $575.44 | Professional | 53 · Discontinued | $173.78 | $173.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $2,187.76 | Professional | 54 · Surgery only | $645.65 | $645.65 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $436.52 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $288.40 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $190.55 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $190.55 |
Where Ohio sits
The same service costs 5.6 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
$891
AK $3,548UT $631
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.