How much rates vary
Facilitymedian $2,042 · 10th to 90th $646 to $8,913Professionalmedian $708 · 10th to 90th $93 to $1,072
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 $1,949.84 Median $6,606.93 Typical High $12,589.25 | Facility | None | $1,949.84 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $8,709.64 | Professional | None | $724.44 | $724.44 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,122.02 | Professional | None | $562.34 | $691.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,023.29 Typical High $1,659.59 | Professional | 50 · Both sides | $851.14 | $1,023.29 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $109.65 Typical High $177.83 | Professional | 80 · Assistant surgeon | $91.20 | $109.65 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,621.81 Typical High $2,137.96 | Facility | None | $870.96 | $1,621.81 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $2,884.03 | Facility | None | $549.54 | $1,862.09 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,445.44 | Professional | None | $630.96 | $776.25 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $2,818.38 | Facility | None | $549.54 | $1,862.09 | $2,818.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,445.44 | Professional | None | $630.96 | $776.25 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $676.08 Typical High $954.99 | Professional | None | $79.43 | $676.08 | $954.99 |
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 $660.69 Median $660.69 Typical High $1,000.00 | Professional | None | $660.69 | $660.69 | $1,000.00 |
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 $616.60 Median $794.33 Typical High $1,659.59 | Professional | None | $616.60 | $794.33 | $1,659.59 |
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 $363.08 Median $363.08 Typical High $1,380.38 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $562.34 | Professional | 53 · Discontinued | $147.91 | $147.91 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $2,089.30 | Professional | 54 · Surgery only | $549.54 | $549.54 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $416.87 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $281.84 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $1,949.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $95.50 Typical High $154.88 | Professional | AS · PA/NP assist | $79.43 | $95.50 | $154.88 |
Where Ohio sits
The same service costs 6.3 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
$724
OK $3,311UT $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.