How much rates vary
Facilitymedian $1,862 · 10th to 90th $631 to $8,710Professionalmedian $724 · 10th to 90th $91 to $1,096
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $9,120.11 | Professional | None | $758.58 | $758.58 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,778.28 Typical High $7,585.78 | Facility | None | $660.69 | $1,778.28 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,174.90 | Professional | None | $588.84 | $724.44 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,071.52 Typical High $1,737.80 | Professional | 50 · Both sides | $870.96 | $1,071.52 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $114.82 Typical High $186.21 | Professional | 80 · Assistant surgeon | $93.33 | $114.82 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $100.00 Typical High $162.18 | Professional | AS · PA/NP assist | $81.28 | $100.00 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $2,818.38 | Facility | None | $549.54 | $1,819.70 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,513.56 | Professional | None | $660.69 | $812.83 | $1,513.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $2,754.23 | Facility | None | $549.54 | $1,819.70 | $2,754.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,513.56 | Professional | None | $660.69 | $812.83 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $707.95 Typical High $1,000.00 | Professional | None | $79.43 | $707.95 | $1,000.00 |
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 $691.83 Median $691.83 Typical High $1,047.13 | Professional | None | $691.83 | $691.83 | $1,047.13 |
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 $660.69 Median $851.14 Typical High $1,698.24 | Professional | None | $660.69 | $851.14 | $1,698.24 |
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 $380.19 Median $380.19 Typical High $1,288.25 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $512.86 | Professional | 53 · Discontinued | $151.36 | $151.36 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $1,905.46 | Professional | 54 · Surgery only | $575.44 | $575.44 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $380.19 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $257.04 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $1,778.28 |
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
$741
AK $3,020UT $525
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.