How much rates vary
Facilitymedian $3,802 · 10th to 90th $525 to $16,218Professionalmedian $741 · 10th to 90th $138 to $1,148
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 $2,137.96 Median $9,120.11 Typical High $12,589.25 | Facility | None | $2,137.96 | $9,120.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $9,772.37 | Professional | None | $776.25 | $776.25 | $9,772.37 |
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 $575.44 Median $691.83 Typical High $1,148.15 | Professional | None | $575.44 | $691.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $436.52 Typical High $724.44 | Professional | 62 · Two surgeons | $363.08 | $436.52 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
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 $691.83 Median $1,023.29 Typical High $1,659.59 | Professional | None | $691.83 | $1,023.29 | $1,659.59 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,659.59 | Professional | None | $691.83 | $1,023.29 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $691.83 Typical High $1,000.00 | Professional | None | $123.03 | $691.83 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,148.15 | Professional | None | $724.44 | $724.44 | $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 $707.95 Median $912.01 Typical High $1,995.26 | Professional | None | $707.95 | $912.01 | $1,995.26 |
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 $389.05 Median $389.05 Typical High $1,445.44 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $575.44 | Professional | 53 · Discontinued | $154.88 | $154.88 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $588.84 | $588.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $436.52 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $288.40 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $194.98 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $97.72 Typical High $162.18 | Professional | AS · PA/NP assist | $79.43 | $97.72 | $162.18 |
Where Ohio sits
The same service costs 6.2 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
$776
AK $3,236UT $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.