How much rates vary
Facilitymedian $2,042 · 10th to 90th $661 to $7,943Professionalmedian $933 · 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 $2,454.71 Median $5,754.40 Typical High $12,022.64 | Facility | None | $2,454.71 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $7,762.47 | Professional | None | $954.99 | $954.99 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $4,786.30 | Facility | None | $602.56 | $1,479.11 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,479.11 | Professional | None | $758.58 | $933.25 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $602.56 Typical High $933.25 | Professional | 62 · Two surgeons | $478.63 | $602.56 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $151.36 Typical High $239.88 | Professional | 80 · Assistant surgeon | $123.03 | $151.36 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,089.30 | Facility | None | $1,148.15 | $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 $831.76 Median $1,023.29 Typical High $1,905.46 | Professional | None | $831.76 | $1,023.29 | $1,905.46 |
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 $831.76 Median $1,023.29 Typical High $1,905.46 | Professional | None | $831.76 | $1,023.29 | $1,905.46 |
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 $870.96 Median $870.96 Typical High $1,318.26 | Professional | None | $870.96 | $870.96 | $1,318.26 |
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 $870.96 Median $1,071.52 Typical High $2,187.76 | Professional | None | $870.96 | $1,071.52 | $2,187.76 |
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 $478.63 Median $478.63 Typical High $2,137.96 | Professional | 52 · Reduced service | $478.63 | $478.63 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $851.14 | Professional | 53 · Discontinued | $194.98 | $194.98 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $3,162.28 | Professional | 54 · Surgery only | $724.44 | $724.44 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $630.96 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $426.58 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $2,951.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $208.93 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $208.93 |
Where Ohio sits
The same service costs 6.2 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· 49th of 51
$955
OK $4,074UT $661
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.