How much rates vary
Facilitymedian $1,862 · 10th to 90th $617 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 $1,737.80 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,737.80 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $9,120.11 | Professional | None | $426.58 | $426.58 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,174.90 Typical High $4,786.30 | Facility | None | $562.34 | $1,174.90 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $660.69 | Professional | None | $323.59 | $398.11 | $660.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $204.17 Median $251.19 Typical High $416.87 | Professional | 62 · Two surgeons | $204.17 | $251.19 | $416.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $63.10 Typical High $104.71 | Professional | 80 · Assistant surgeon | $51.29 | $63.10 | $104.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $56.23 Typical High $93.33 | Professional | AS · PA/NP assist | $44.67 | $56.23 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $1,621.81 Typical High $2,089.30 | Facility | None | $537.03 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,818.38 | Facility | None | $602.56 | $1,862.09 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $891.25 | Professional | None | $398.11 | $537.03 | $891.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,691.53 | Facility | None | $602.56 | $1,862.09 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $891.25 | Professional | None | $398.11 | $537.03 | $891.25 |
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 $398.11 Median $398.11 Typical High $616.60 | Professional | None | $398.11 | $398.11 | $616.60 |
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 $389.05 Median $478.63 Typical High $1,096.48 | Professional | None | $389.05 | $478.63 | $1,096.48 |
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 $213.80 Median $213.80 Typical High $281.84 | Professional | 52 · Reduced service | $213.80 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $389.05 |
Where Ohio sits
The same service costs 7.1 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
$427
AK $2,042UT $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.