How much rates vary
Facilitymedian $5,012 · 10th to 90th $646 to $21,380Professionalmedian $776 · 10th to 90th $78 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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $4,786.30 | Professional | None | $794.33 | $794.33 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $4,570.88 Typical High $20,892.96 | Facility | None | $776.25 | $4,570.88 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,202.26 | Professional | None | $616.60 | $724.44 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $457.09 Typical High $758.58 | Professional | 62 · Two surgeons | $389.05 | $457.09 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $117.49 Typical High $199.53 | Professional | 80 · Assistant surgeon | $100.00 | $117.49 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $16,218.10 Typical High $21,379.62 | Facility | None | $977.24 | $16,218.10 | $21,379.62 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $16,595.87 Typical High $26,302.68 | Facility | None | $489.78 | $16,595.87 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,621.81 | Professional | None | $707.95 | $870.96 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $16,595.87 Typical High $26,302.68 | Facility | None | $512.86 | $16,595.87 | $26,302.68 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,621.81 | Professional | None | $707.95 | $870.96 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $707.95 Typical High $1,047.13 | Professional | None | $63.10 | $707.95 | $1,047.13 |
SummaCare Setting Facility Modifier None Typical Low $9,120.11 Median $9,549.93 Typical High $10,715.19 | Facility | None | $9,120.11 | $9,549.93 | $10,715.19 |
SummaCare Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,122.02 | Professional | None | $741.31 | $741.31 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,905.46 | Professional | None | $758.58 | $912.01 | $1,905.46 |
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 $398.11 Median $398.11 Typical High $1,513.56 | Professional | 52 · Reduced service | $398.11 | $398.11 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $602.56 | Professional | 53 · Discontinued | $158.49 | $158.49 | $602.56 |
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 $79.43 Median $79.43 Typical High $302.00 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $302.00 |
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 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $169.82 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $169.82 |
Where Ohio sits
The same service costs 6.8 times more in Alaska than in Texas. 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
$794
AK $3,715TX $550
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.