How much rates vary
Facilitymedian $2,291 · 10th to 90th $708 to $9,120Professionalmedian $955 · 10th to 90th $138 to $1,445
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 $1,778.28 Median $4,466.84 Typical High $11,220.18 | Facility | None | $1,778.28 | $4,466.84 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $7,762.47 | Professional | None | $1,000.00 | $1,000.00 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,862.09 Typical High $7,585.78 | Facility | None | $660.69 | $1,862.09 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,548.82 | Professional | None | $794.33 | $977.24 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $616.60 Typical High $954.99 | Professional | 62 · Two surgeons | $501.19 | $616.60 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,089.30 | Facility | None | $1,202.26 | $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 $851.14 Median $1,047.13 Typical High $1,949.84 | Professional | None | $851.14 | $1,047.13 | $1,949.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,754.23 | Facility | None | $602.56 | $1,819.70 | $2,754.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,949.84 | Professional | None | $851.14 | $1,047.13 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $891.25 Typical High $1,258.93 | Professional | None | $123.03 | $891.25 | $1,258.93 |
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 $891.25 Median $891.25 Typical High $1,380.38 | Professional | None | $891.25 | $891.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $2,238.72 | Professional | None | $891.25 | $1,096.48 | $2,238.72 |
8 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 $501.19 Median $501.19 Typical High $2,137.96 | Professional | 52 · Reduced service | $501.19 | $501.19 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $870.96 | Professional | 53 · Discontinued | $199.53 | $199.53 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $3,235.94 | Professional | 54 · Surgery only | $741.31 | $741.31 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $645.65 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $436.52 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $151.36 Typical High $245.47 | Professional | 80 · Assistant surgeon | $125.89 | $151.36 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $134.90 Typical High $213.80 | Professional | AS · PA/NP assist | $109.65 | $134.90 | $213.80 |
Where Ohio sits
The same service costs 5.9 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
$1,000
OK $4,074UT $692
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.