How much rates vary
Facilitymedian $1,950 · 10th to 90th $759 to $8,913Professionalmedian $501 · 10th to 90th $347 to $741
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 $1,348.96 Median $6,606.93 Typical High $12,589.25 | Facility | None | $1,348.96 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $8,912.51 | Professional | None | $501.19 | $501.19 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $7,762.47 | Facility | None | $691.83 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $758.58 | Professional | None | $380.19 | $457.09 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $691.83 Typical High $1,148.15 | Professional | 50 · Both sides | $575.44 | $691.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $74.13 Typical High $123.03 | Professional | 80 · Assistant surgeon | $61.66 | $74.13 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $64.57 Typical High $107.15 | Professional | AS · PA/NP assist | $53.70 | $64.57 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,137.96 | Facility | None | $602.56 | $1,621.81 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,862.09 Typical High $3,162.28 | Facility | None | $741.31 | $1,862.09 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,000.00 | Professional | None | $436.52 | $537.03 | $1,000.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,862.09 Typical High $3,162.28 | Facility | None | $741.31 | $1,862.09 | $3,162.28 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,000.00 | Professional | None | $436.52 | $537.03 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $489.78 Typical High $660.69 | Professional | None | $57.54 | $489.78 | $660.69 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $691.83 | Professional | None | $457.09 | $457.09 | $691.83 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $1,148.15 | Professional | None | $436.52 | $562.34 | $1,148.15 |
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 $251.19 Median $251.19 Typical High $870.96 | Professional | 52 · Reduced service | $251.19 | $251.19 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $346.74 | Professional | 53 · Discontinued | $100.00 | $100.00 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $1,318.26 | Professional | 54 · Surgery only | $380.19 | $380.19 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $263.03 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $173.78 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $1,230.27 |
Where Ohio sits
The same service costs 10.0 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
$525
OK $3,631UT $363
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.