How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $1,698 · 10th to 90th $275 to $2,630
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 $1,548.82 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,548.82 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $9,120.11 | Professional | None | $1,548.82 | $1,548.82 | $9,120.11 |
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 $1,288.25 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,548.82 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $977.24 Typical High $1,698.24 | Professional | 62 · Two surgeons | $812.83 | $977.24 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $426.58 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,621.81 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,187.76 | $3,630.78 |
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 $1,621.81 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,187.76 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $1,621.81 Typical High $2,398.83 | Professional | None | $239.88 | $1,621.81 | $2,398.83 |
SummaCare Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,698.24 | $1,698.24 | $2,570.40 |
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 $1,548.82 Median $2,187.76 Typical High $4,168.69 | Professional | None | $1,548.82 | $2,187.76 | $4,168.69 |
7 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 $776.25 Median $776.25 Typical High $3,090.30 | Professional | 52 · Reduced service | $776.25 | $776.25 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $1,258.93 | Professional | 53 · Discontinued | $309.03 | $309.03 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $933.25 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $616.60 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $4,365.16 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $371.54 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $371.54 |
Where Ohio sits
The same service costs 5.9 times more in Alaska 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· 43rd of 51
$1,738
AK $6,918TX $1,175
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.