How much rates vary
Facilitymedian $2,138 · 10th to 90th $676 to $8,511Professionalmedian $813 · 10th to 90th $93 to $1,259
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 $2,290.87 Median $5,754.40 Typical High $12,022.64 | Facility | None | $2,290.87 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $7,762.47 | Professional | None | $831.76 | $831.76 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $7,585.78 | Facility | None | $645.65 | $1,737.80 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,318.26 | Professional | None | $676.08 | $831.76 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $524.81 Typical High $831.76 | Professional | 62 · Two surgeons | $426.58 | $524.81 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $131.83 Typical High $213.80 | Professional | 80 · Assistant surgeon | $107.15 | $131.83 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $186.21 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,819.70 Typical High $2,754.23 | Facility | None | $562.34 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,659.59 | Professional | None | $724.44 | $891.25 | $1,659.59 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,691.53 | Facility | None | $602.56 | $1,819.70 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,659.59 | Professional | None | $724.44 | $891.25 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $758.58 Typical High $1,096.48 | Professional | None | $79.43 | $758.58 | $1,096.48 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Professional | None | $758.58 | $758.58 | $1,202.26 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,905.46 | Professional | None | $758.58 | $933.25 | $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 $416.87 Median $416.87 Typical High $1,412.54 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $562.34 | Professional | 53 · Discontinued | $165.96 | $165.96 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,089.30 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $416.87 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $281.84 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $1,949.84 |
Where Ohio sits
The same service costs 6.6 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
$832
OK $3,802UT $575
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.