How much rates vary
Facilitymedian $1,862 · 10th to 90th $692 to $6,918Professionalmedian $363 · 10th to 90th $240 to $575
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 $1,659.59 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,659.59 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $4,570.88 | Professional | None | $363.08 | $363.08 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,570.88 | Facility | None | $524.81 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $645.65 | Professional | None | $302.00 | $354.81 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $223.87 Typical High $407.38 | Professional | 62 · Two surgeons | $190.55 | $223.87 | $407.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $57.54 Typical High $104.71 | Professional | 80 · Assistant surgeon | $47.86 | $57.54 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $1,621.81 Typical High $2,089.30 | Facility | None | $457.09 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $3,388.44 | Facility | None | $794.33 | $1,862.09 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $758.58 | Professional | None | $354.81 | $467.74 | $758.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $3,388.44 | Facility | None | $794.33 | $1,862.09 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $758.58 | Professional | None | $354.81 | $467.74 | $758.58 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $346.74 Typical High $501.19 | Professional | None | $57.54 | $346.74 | $501.19 |
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 $338.84 Median $338.84 Typical High $512.86 | Professional | None | $338.84 | $338.84 | $512.86 |
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 $331.13 Median $436.52 Typical High $933.25 | Professional | None | $331.13 | $436.52 | $933.25 |
7 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 $181.97 Median $181.97 Typical High $831.76 | Professional | 52 · Reduced service | $181.97 | $181.97 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $331.13 | Professional | 53 · Discontinued | $72.44 | $72.44 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $1,230.27 | Professional | 54 · Surgery only | $269.15 | $269.15 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $245.47 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $165.96 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $1,148.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $50.12 Typical High $91.20 | Professional | AS · PA/NP assist | $41.69 | $50.12 | $91.20 |
Where Ohio sits
The same service costs 7.1 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
$389
OK $1,950UT $275
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.