How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $9,550Professionalmedian $692 · 10th to 90th $93 to $1,072
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 $1,318.26 Median $6,918.31 Typical High $12,022.64 | Facility | None | $1,318.26 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $7,943.28 | Professional | None | $741.31 | $741.31 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $7,079.46 | Facility | None | $691.83 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,122.02 | Professional | None | $562.34 | $707.95 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $707.95 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $112.20 Typical High $177.83 | Professional | 80 · Assistant surgeon | $91.20 | $112.20 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $2,454.71 Typical High $3,162.28 | Facility | None | $870.96 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,691.53 Typical High $4,365.16 | Facility | None | $562.34 | $2,691.53 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,445.44 | Professional | None | $630.96 | $776.25 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $4,168.69 | Facility | None | $602.56 | $2,691.53 | $4,168.69 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,445.44 | Professional | None | $630.96 | $776.25 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $660.69 Typical High $954.99 | Professional | None | $79.43 | $660.69 | $954.99 |
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 $660.69 Median $660.69 Typical High $1,047.13 | Professional | None | $660.69 | $660.69 | $1,047.13 |
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 $616.60 Median $794.33 Typical High $1,659.59 | Professional | None | $616.60 | $794.33 | $1,659.59 |
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 $371.54 Median $371.54 Typical High $1,230.27 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $489.78 | Professional | 53 · Discontinued | $147.91 | $147.91 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $1,819.70 | Professional | 54 · Surgery only | $549.54 | $549.54 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $371.54 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $245.47 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $95.50 Typical High $158.49 | Professional | AS · PA/NP assist | $79.43 | $95.50 | $158.49 |
Where Ohio sits
The same service costs 8.7 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· 48th of 51
$724
OK $4,365UT $501
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.