How much rates vary
Facilitymedian $5,129 · 10th to 90th $631 to $16,218Professionalmedian $525 · 10th to 90th $93 to $794
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 $1,995.26 Median $8,511.38 Typical High $13,803.84 | Facility | None | $1,995.26 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $9,120.11 | Professional | None | $537.03 | $537.03 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $19,498.45 | Facility | None | $1,047.13 | $7,943.28 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $812.83 | Professional | None | $398.11 | $478.63 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $302.00 Typical High $512.86 | Professional | 62 · Two surgeons | $251.19 | $302.00 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,548.82 | Facility | None | $676.08 | $1,023.29 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,122.02 | Professional | None | $489.78 | $691.83 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,122.02 | Professional | None | $489.78 | $691.83 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $707.95 | Professional | None | $79.43 | $489.78 | $707.95 |
SummaCare Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $776.25 | Professional | None | $512.86 | $512.86 | $776.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,819.70 Typical High $7,244.36 | Facility | None | $707.95 | $1,819.70 | $7,244.36 |
United Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,380.38 | Professional | None | $478.63 | $630.96 | $1,380.38 |
8 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 $269.15 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $524.81 | Professional | 54 · Surgery only | $407.38 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $77.62 Typical High $128.82 | Professional | 80 · Assistant surgeon | $64.57 | $77.62 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $67.61 Typical High $114.82 | Professional | AS · PA/NP assist | $56.23 | $67.61 | $114.82 |
Where Ohio sits
The same service costs 6.0 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· 48th of 51
$537
AK $2,239UT $372
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.