How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $1,202 · 10th to 90th $229 to $1,862
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 $1,096.48 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,096.48 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $5,248.07 | Professional | None | $1,096.48 | $1,096.48 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $12,022.64 Typical High $28,183.83 | Facility | None | $1,479.11 | $12,022.64 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,737.80 | Professional | None | $691.83 | $977.24 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $616.60 Typical High $1,071.52 | Professional | 62 · Two surgeons | $436.52 | $616.60 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $1,148.15 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,548.82 | $2,454.71 |
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 $1,174.90 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,548.82 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,202.26 Typical High $1,737.80 | Professional | None | $199.53 | $1,202.26 | $1,737.80 |
SummaCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,230.27 | $1,621.81 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,951.21 | Professional | None | $954.99 | $1,288.25 | $2,951.21 |
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 $549.54 Median $549.54 Typical High $2,041.74 | Professional | 52 · Reduced service | $549.54 | $549.54 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $812.83 | Professional | 53 · Discontinued | $218.78 | $218.78 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $3,090.30 | Professional | 54 · Surgery only | $812.83 | $812.83 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $616.60 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $407.38 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $151.36 Typical High $275.42 | Professional | 80 · Assistant surgeon | $112.20 | $151.36 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $134.90 Typical High $239.88 | Professional | AS · PA/NP assist | $97.72 | $134.90 | $239.88 |
Where Ohio sits
The same service costs 5.6 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· 43rd of 51
$1,230
AK $5,012UT $891
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.