How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $1,380 · 10th to 90th $224 to $2,089
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 $1,230.27 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,230.27 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $9,120.11 | Professional | None | $1,230.27 | $1,230.27 | $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 $1,000.00 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,202.26 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $1,348.96 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $346.74 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $1,318.26 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,778.28 | $2,884.03 |
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 $1,318.26 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,778.28 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,348.96 Typical High $1,949.84 | Professional | None | $199.53 | $1,348.96 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,380.38 | $2,089.30 |
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 $1,288.25 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,737.80 | $3,388.44 |
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 $616.60 Median $616.60 Typical High $2,884.03 | Professional | 52 · Reduced service | $616.60 | $616.60 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $1,148.15 | Professional | 53 · Discontinued | $245.47 | $245.47 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $4,265.80 | Professional | 54 · Surgery only | $933.25 | $933.25 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $851.14 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $575.44 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $3,981.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $302.00 |
Where Ohio sits
The same service costs 5.8 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
$1,413
AK $5,623TX $977
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.