How much rates vary
Facilitymedian $3,236 · 10th to 90th $813 to $10,471Professionalmedian $562 · 10th to 90th $93 to $871
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $8,709.64 | Professional | None | $549.54 | $562.34 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $8,128.31 | Facility | None | $794.33 | $2,691.53 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $912.01 | Professional | None | $467.74 | $549.54 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $346.74 Typical High $575.44 | Professional | 62 · Two surgeons | $295.12 | $346.74 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $3,630.78 | Facility | None | $724.44 | $2,754.23 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,951.21 Typical High $4,897.79 | Facility | None | $741.31 | $2,951.21 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $1,202.26 | Professional | None | $537.03 | $616.60 | $1,202.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $4,570.88 | Facility | None | $741.31 | $3,019.95 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,202.26 | Professional | None | $512.86 | $602.56 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $549.54 Typical High $776.25 | Professional | None | $79.43 | $549.54 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $812.83 | Professional | None | $537.03 | $537.03 | $812.83 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,318.26 | Professional | None | $489.78 | $645.65 | $1,318.26 |
8 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 $275.42 Median $275.42 Typical High $1,445.44 | Professional | 52 · Reduced service | $275.42 | $275.42 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $575.44 | Professional | 53 · Discontinued | $112.20 | $112.20 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $2,137.96 | Professional | 54 · Surgery only | $416.87 | $416.87 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $426.58 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $288.40 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $87.10 Typical High $147.91 | Professional | 80 · Assistant surgeon | $74.13 | $87.10 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $75.86 Typical High $128.82 | Professional | AS · PA/NP assist | $64.57 | $75.86 | $128.82 |
Where Ohio sits
The same service costs 8.1 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· 49th of 51
$589
OK $3,467UT $427
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.