How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $16,218Professionalmedian $776 · 10th to 90th $138 to $1,175
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 $954.99 Median $10,232.93 Typical High $13,803.84 | Facility | None | $954.99 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $9,120.11 | Professional | None | $812.83 | $812.83 | $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 $616.60 Median $776.25 Typical High $1,288.25 | Professional | None | $616.60 | $776.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $489.78 Typical High $794.33 | Professional | 62 · Two surgeons | $380.19 | $489.78 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $125.89 Typical High $204.17 | Professional | 80 · Assistant surgeon | $97.72 | $125.89 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,737.80 | Facility | None | $891.25 | $1,174.90 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,698.24 | Professional | None | $724.44 | $1,071.52 | $1,698.24 |
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 $724.44 Median $1,071.52 Typical High $1,698.24 | Professional | None | $724.44 | $1,071.52 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $724.44 Typical High $1,047.13 | Professional | None | $123.03 | $724.44 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,148.15 | Professional | None | $758.58 | $758.58 | $1,148.15 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $2,089.30 | Professional | None | $741.31 | $977.24 | $2,089.30 |
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 $407.38 Median $407.38 Typical High $1,445.44 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $575.44 | Professional | 53 · Discontinued | $162.18 | $162.18 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $2,187.76 | Professional | 54 · Surgery only | $616.60 | $616.60 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $436.52 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $288.40 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $2,041.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $109.65 Typical High $181.97 | Professional | AS · PA/NP assist | $85.11 | $109.65 | $181.97 |
Where Ohio sits
The same service costs 6.3 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· 47th of 51
$794
AK $3,388UT $537
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.