How much rates vary
Facilitymedian $851 · 10th to 90th $126 to $10,233Professionalmedian $603 · 10th to 90th $457 to $977
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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $3,467.37 | Professional | None | $524.81 | $524.81 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $1,737.80 Typical High $16,595.87 | Facility | None | $489.78 | $1,737.80 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,023.29 | Professional | None | $467.74 | $588.84 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $371.54 Typical High $630.96 | Professional | 62 · Two surgeons | $295.12 | $371.54 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $100.00 Typical High $467.74 | Professional | 80 · Assistant surgeon | $75.86 | $100.00 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $81.28 Typical High $144.54 | Professional | AS · PA/NP assist | $66.07 | $81.28 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $1,096.48 | Facility | None | $562.34 | $724.44 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $616.60 Typical High $2,691.53 | Facility | None | $436.52 | $616.60 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,122.02 | Professional | None | $575.44 | $776.25 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $2,691.53 | Facility | None | $446.68 | $616.60 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,122.02 | Professional | None | $575.44 | $776.25 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $776.25 | Professional | None | $416.87 | $537.03 | $776.25 |
SummaCare Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $691.83 | Professional | None | $478.63 | $524.81 | $691.83 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $371.54 Median $630.96 Typical High $1,096.48 | Professional | None | $371.54 | $630.96 | $1,096.48 |
5 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 $263.03 Median $263.03 Typical High $1,023.29 | Professional | 52 · Reduced service | $263.03 | $263.03 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $407.38 | Professional | 53 · Discontinued | $104.71 | $104.71 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $1,513.56 | Professional | 54 · Surgery only | $398.11 | $398.11 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $302.00 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $204.17 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $204.17 |
Where Ohio sits
The same service costs 4.9 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· 42nd of 51
$603
AK $2,399UT $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.