How much rates vary
Facilitymedian $2,512 · 10th to 90th $513 to $8,318Professionalmedian $776 · 10th to 90th $93 to $1,175
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 $1,380.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $4,168.69 | Professional | None | $776.25 | $776.25 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $2,137.96 Typical High $7,079.46 | Facility | None | $562.34 | $2,137.96 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,148.15 | Professional | None | $588.84 | $691.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $190.55 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $97.72 Typical High $162.18 | Professional | AS · PA/NP assist | $83.18 | $97.72 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $3,090.30 Typical High $4,073.80 | Facility | None | $977.24 | $3,090.30 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $2,570.40 Typical High $4,168.69 | Facility | None | $363.08 | $2,570.40 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,584.89 | Professional | None | $691.83 | $851.14 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $2,570.40 Typical High $4,073.80 | Facility | None | $389.05 | $2,570.40 | $4,073.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,621.81 | Professional | None | $691.83 | $851.14 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $758.58 Typical High $1,071.52 | Professional | None | $79.43 | $758.58 | $1,071.52 |
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 $724.44 Median $724.44 Typical High $1,122.02 | Professional | None | $724.44 | $724.44 | $1,122.02 |
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 $724.44 Median $891.25 Typical High $1,905.46 | Professional | None | $724.44 | $891.25 | $1,905.46 |
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 $389.05 Median $389.05 Typical High $1,479.11 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $588.84 | Professional | 53 · Discontinued | $154.88 | $154.88 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $2,238.72 | Professional | 54 · Surgery only | $588.84 | $588.84 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $446.68 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $295.12 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $2,089.30 |
Where Ohio sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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.
Physician feeFacility fee
OK $9,757HI $1,932
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.