How much rates vary
Facilitymedian $3,467 · 10th to 90th $490 to $11,749Professionalmedian $1,288 · 10th to 90th $195 to $2,042
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 $1,318.26 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,318.26 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $5,370.32 | Professional | None | $1,318.26 | $1,318.26 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $6,165.95 Typical High $12,882.50 | Facility | None | $933.25 | $6,165.95 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,187.76 | Professional | None | $977.24 | $1,230.27 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $218.78 Typical High $977.24 | Professional | 80 · Assistant surgeon | $158.49 | $218.78 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,445.44 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,862.09 | $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 $1,513.56 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,513.56 | $1,862.09 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,174.90 Typical High $1,862.09 | Professional | None | $165.96 | $1,174.90 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,445.44 | $1,905.46 |
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 $891.25 Median $1,479.11 Typical High $2,570.40 | Professional | None | $891.25 | $1,479.11 | $2,570.40 |
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 $660.69 Median $660.69 Typical High $2,344.23 | Professional | 52 · Reduced service | $660.69 | $660.69 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $933.25 | Professional | 53 · Discontinued | $263.03 | $263.03 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $3,467.37 | Professional | 54 · Surgery only | $977.24 | $977.24 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $707.95 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $467.74 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $776.25 Typical High $1,380.38 | Professional | 62 · Two surgeons | $616.60 | $776.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $169.82 Typical High $309.03 | Professional | AS · PA/NP assist | $138.04 | $169.82 | $309.03 |
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· 47th of 51
$1,318
AK $5,888TX $1,000
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.