How much rates vary
Facilitymedian $2,399 · 10th to 90th $646 to $9,333Professionalmedian $407 · 10th to 90th $295 to $692
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 $575.44 Median $5,370.32 Typical High $12,589.25 | Facility | None | $575.44 | $5,370.32 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $7,762.47 | Professional | None | $302.00 | $380.19 | $7,762.47 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $7,079.46 | Facility | None | $691.83 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $616.60 | Professional | None | $316.23 | $407.38 | $616.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $251.19 Typical High $389.05 | Professional | 62 · Two surgeons | $199.53 | $251.19 | $389.05 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $64.57 Typical High $97.72 | Professional | 80 · Assistant surgeon | $50.12 | $64.57 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $56.23 Typical High $87.10 | Professional | AS · PA/NP assist | $43.65 | $56.23 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $2,137.96 Typical High $2,818.38 | Facility | None | $389.05 | $2,137.96 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,715.35 | Facility | None | $602.56 | $2,398.83 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $741.31 | Professional | None | $281.84 | $407.38 | $741.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,467.37 | Facility | None | $602.56 | $2,398.83 | $3,467.37 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $741.31 | Professional | None | $281.84 | $407.38 | $741.31 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $501.19 | Professional | None | $295.12 | $371.54 | $501.19 |
SummaCare Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,174.90 | $1,230.27 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $537.03 | Professional | None | $281.84 | $281.84 | $537.03 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $794.33 | Professional | None | $295.12 | $446.68 | $794.33 |
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 $151.36 Median $151.36 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | 53 · Discontinued | $60.26 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | 54 · Surgery only | $229.09 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $39.81 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $39.81 | $39.81 |
Where Ohio sits
The same service costs 10.0 times more in Oklahoma than in New York. 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· 46th of 51
$407
OK $2,884NY $288
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.