How much rates vary
Facilitymedian $4,677 · 10th to 90th $513 to $16,218Professionalmedian $851 · 10th to 90th $138 to $1,318
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 $3,311.31 Median $10,000.00 Typical High $13,803.84 | Facility | None | $3,311.31 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $10,964.78 | Professional | None | $891.25 | $891.25 | $10,964.78 |
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 $707.95 Median $831.76 Typical High $1,380.38 | Professional | None | $707.95 | $831.76 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $234.42 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $194.98 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $794.33 Median $1,174.90 Typical High $1,905.46 | Professional | None | $794.33 | $1,174.90 | $1,905.46 |
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 $794.33 Median $1,174.90 Typical High $1,905.46 | Professional | None | $794.33 | $1,174.90 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $776.25 Typical High $1,122.02 | Professional | None | $123.03 | $776.25 | $1,122.02 |
SummaCare Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,288.25 | Professional | None | $831.76 | $831.76 | $1,288.25 |
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 $812.83 Median $1,071.52 Typical High $2,290.87 | Professional | None | $812.83 | $1,071.52 | $2,290.87 |
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 $446.68 Median $446.68 Typical High $1,584.89 | Professional | 52 · Reduced service | $446.68 | $446.68 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $645.65 | Professional | 53 · Discontinued | $177.83 | $177.83 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $2,398.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $478.63 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $323.59 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $2,238.72 |
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
$871
AK $3,715UT $589
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.