How much rates vary
Facilitymedian $3,388 · 10th to 90th $708 to $10,000Professionalmedian $1,072 · 10th to 90th $129 to $1,738
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $5,888.44 | Professional | None | $1,174.90 | $1,174.90 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $7,079.46 | Facility | None | $691.83 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,949.84 | Professional | None | $933.25 | $1,148.15 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $204.17 Typical High $933.25 | Professional | 80 · Assistant surgeon | $147.91 | $204.17 | $933.25 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $3,019.95 Typical High $3,890.45 | Facility | None | $1,621.81 | $3,019.95 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $6,309.57 | Facility | None | $602.56 | $3,981.07 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,737.80 | $2,290.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $6,165.95 | Facility | None | $602.56 | $3,981.07 | $6,165.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,737.80 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $870.96 Typical High $1,479.11 | Professional | None | $104.71 | $870.96 | $1,479.11 |
SummaCare Setting Facility Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,570.40 | Facility | None | $2,137.96 | $2,238.72 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,230.27 | $1,584.89 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $2,398.83 | Professional | None | $831.76 | $1,380.38 | $2,398.83 |
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 $588.84 Median $588.84 Typical High $2,290.87 | Professional | 52 · Reduced service | $588.84 | $588.84 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $912.01 | Professional | 53 · Discontinued | $234.42 | $234.42 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $3,388.44 | Professional | 54 · Surgery only | $891.25 | $891.25 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $691.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $457.09 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $724.44 Typical High $1,230.27 | Professional | 62 · Two surgeons | $588.84 | $724.44 | $1,230.27 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $162.18 Typical High $275.42 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $275.42 |
Where Ohio sits
The same service costs 11.0 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· 48th of 51
$1,096
AK $5,370TX $490
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.