How much rates vary
Facilitymedian $5,370 · 10th to 90th $661 to $16,218Professionalmedian $676 · 10th to 90th $174 to $1,148
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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $8,912.51 | Professional | None | $660.69 | $660.69 | $8,912.51 |
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 $645.65 Median $758.58 Typical High $1,258.93 | Professional | None | $645.65 | $758.58 | $1,258.93 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $724.44 Median $831.76 Typical High $1,659.59 | Professional | None | $724.44 | $831.76 | $1,659.59 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,698.24 | Professional | None | $724.44 | $831.76 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $489.78 Typical High $977.24 | Professional | None | $158.49 | $489.78 | $977.24 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,148.15 | Professional | None | $758.58 | $758.58 | $1,148.15 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,862.09 | Professional | None | $741.31 | $891.25 | $1,862.09 |
9 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 $331.13 Median $331.13 Typical High $489.78 | Professional | 52 · Reduced service | $331.13 | $331.13 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $194.98 | Professional | 53 · Discontinued | $131.83 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $741.31 | Professional | 54 · Surgery only | $489.78 | $489.78 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $147.91 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $97.72 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $794.33 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $199.53 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $177.83 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $177.83 |
Where Ohio sits
The same service costs 8.5 times more in Oklahoma than in Texas. 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
$724
OK $3,162TX $372
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.