How much rates vary
Facilitymedian $2,818 · 10th to 90th $708 to $10,233Professionalmedian $1,380 · 10th to 90th $182 to $2,089
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $9,332.54 | Professional | None | $1,445.44 | $1,445.44 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $10,232.93 | Facility | None | $691.83 | $2,290.87 | $10,232.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,445.44 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $912.01 Typical High $1,445.44 | Professional | 62 · Two surgeons | $741.31 | $912.01 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $371.54 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $323.59 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $3,162.28 | Facility | None | $1,737.80 | $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 $1,230.27 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,548.82 | $2,884.03 |
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 $1,230.27 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,548.82 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,288.25 Typical High $1,819.70 | Professional | None | $162.18 | $1,288.25 | $1,819.70 |
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 $1,288.25 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,288.25 | $2,238.72 |
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 $1,318.26 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,621.81 | $3,235.94 |
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 $724.44 Median $724.44 Typical High $2,951.21 | Professional | 52 · Reduced service | $724.44 | $724.44 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $1,174.90 | Professional | 53 · Discontinued | $288.40 | $288.40 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $870.96 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $588.84 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $4,073.80 |
Where Ohio sits
The same service costs 5.8 times more in Alaska 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
$1,413
AK $5,623UT $977
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.