How much rates vary
Facilitymedian $1,862 · 10th to 90th $589 to $7,762Professionalmedian $398 · 10th to 90th $69 to $631
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 $1,698.24 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,698.24 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $7,762.47 | Professional | None | $416.87 | $416.87 | $7,762.47 |
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 $316.23 Median $407.38 Typical High $676.08 | Professional | None | $316.23 | $407.38 | $676.08 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $257.04 Typical High $426.58 | Professional | 62 · Two surgeons | $199.53 | $257.04 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $64.57 Typical High $109.65 | Professional | 80 · Assistant surgeon | $50.12 | $64.57 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $54.95 Typical High $95.50 | Professional | AS · PA/NP assist | $43.65 | $54.95 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $1,621.81 Typical High $2,089.30 | Facility | None | $524.81 | $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 $389.05 Median $524.81 Typical High $851.14 | Professional | None | $389.05 | $524.81 | $851.14 |
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 $389.05 Median $524.81 Typical High $851.14 | Professional | None | $389.05 | $524.81 | $851.14 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $338.84 Typical High $524.81 | Professional | None | $54.95 | $338.84 | $524.81 |
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 $389.05 Median $389.05 Typical High $588.84 | Professional | None | $389.05 | $389.05 | $588.84 |
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 $380.19 Median $467.74 Typical High $1,071.52 | Professional | None | $380.19 | $467.74 | $1,071.52 |
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 $208.93 Median $208.93 Typical High $275.42 | Professional | 52 · Reduced service | $208.93 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $407.38 | Professional | 54 · Surgery only | $316.23 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $54.95 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $380.19 |
Where Ohio sits
The same service costs 10.2 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· 48th of 51
$417
OK $2,951UT $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.