How much rates vary
Facilitymedian $1,778 · 10th to 90th $631 to $7,762Professionalmedian $316 · 10th to 90th $79 to $479
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 $891.25 Median $5,754.40 Typical High $12,022.64 | Facility | None | $891.25 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $7,762.47 | Professional | None | $323.59 | $323.59 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,174.90 Typical High $4,786.30 | Facility | None | $562.34 | $1,174.90 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $478.63 | Professional | None | $239.88 | $281.84 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $45.71 Typical High $75.86 | Professional | 80 · Assistant surgeon | $38.90 | $45.71 | $75.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $39.81 Typical High $67.61 | Professional | AS · PA/NP assist | $33.88 | $39.81 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $1,621.81 Typical High $2,089.30 | Facility | None | $407.38 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,818.38 | Facility | None | $602.56 | $1,862.09 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $645.65 | Professional | None | $288.40 | $407.38 | $645.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,691.53 | Facility | None | $602.56 | $1,862.09 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $645.65 | Professional | None | $288.40 | $407.38 | $645.65 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $288.40 Typical High $436.52 | Professional | None | $63.10 | $288.40 | $436.52 |
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 $302.00 Median $302.00 Typical High $457.09 | Professional | None | $302.00 | $302.00 | $457.09 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $831.76 | Professional | None | $288.40 | $363.08 | $831.76 |
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 $162.18 Median $162.18 Typical High $213.80 | Professional | 52 · Reduced service | $162.18 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $85.11 | Professional | 53 · Discontinued | $64.57 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $42.66 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $295.12 |
Where Ohio sits
The same service costs 11.2 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
$324
OK $2,512UT $224
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.