How much rates vary
Facilitymedian $1,862 · 10th to 90th $589 to $6,166Professionalmedian $302 · 10th to 90th $224 to $457
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 $1,000.00 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $3,715.35 | Professional | None | $281.84 | $281.84 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $467.74 | Professional | None | $234.42 | $275.42 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $416.87 Typical High $691.83 | Professional | 50 · Both sides | $354.81 | $416.87 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $173.78 Typical High $288.40 | Professional | 62 · Two surgeons | $147.91 | $173.78 | $288.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $44.67 Typical High $75.86 | Professional | 80 · Assistant surgeon | $37.15 | $44.67 | $75.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $38.90 Typical High $64.57 | Professional | AS · PA/NP assist | $33.11 | $38.90 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $1,621.81 Typical High $2,089.30 | Facility | None | $354.81 | $1,621.81 | $2,089.30 |
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 $263.03 Median $363.08 Typical High $588.84 | Professional | None | $263.03 | $363.08 | $588.84 |
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 $263.03 Median $363.08 Typical High $588.84 | Professional | None | $263.03 | $363.08 | $588.84 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $416.87 | Professional | None | $194.98 | $309.03 | $416.87 |
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 $263.03 Median $263.03 Typical High $389.05 | Professional | None | $263.03 | $263.03 | $389.05 |
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 $257.04 Median $331.13 Typical High $724.44 | Professional | None | $257.04 | $331.13 | $724.44 |
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 $141.25 Median $141.25 Typical High $186.21 | Professional | 52 · Reduced service | $141.25 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | 53 · Discontinued | $56.23 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | 54 · Surgery only | $213.80 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $263.03 |
Where Ohio sits
The same service costs 6.0 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· 47th of 51
$324
OK $1,479UT $245
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.