How much rates vary
Facilitymedian $4,571 · 10th to 90th $891 to $11,749Professionalmedian $1,995 · 10th to 90th $1,148 to $3,090
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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $8,128.31 | Professional | None | $1,148.15 | $1,148.15 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,548.13 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,584.89 | $2,041.74 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $323.59 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $251.19 | $323.59 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $288.40 Typical High $446.68 | Professional | AS · PA/NP assist | $223.87 | $288.40 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $19,054.61 Typical High $33,884.42 | Professional | None | $1,513.56 | $19,054.61 | $33,884.42 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $7,585.78 | Facility | None | $549.54 | $4,466.84 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $549.54 | $4,466.84 | $7,079.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
SummaCare Setting Facility Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,398.83 | $2,511.89 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $2,238.72 | Professional | None | $776.25 | $1,318.26 | $2,238.72 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Where Ohio sits
The same service costs 5.9 times more in Texas than in Kentucky. 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· 19th of 51
$1,995
TX $5,754KY $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.