How much rates vary
Facilitymedian $617 · 10th to 90th $115 to $4,365Professionalmedian $295 · 10th to 90th $178 to $457
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 $1,513.56 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,513.56 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $4,786.30 | Professional | None | $154.88 | $154.88 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $3,715.35 | Facility | None | $407.38 | $831.76 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $467.74 | Professional | None | $245.47 | $309.03 | $467.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $48.98 Typical High $79.43 | Professional | 80 · Assistant surgeon | $40.74 | $48.98 | $79.43 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $42.66 Typical High $66.07 | Professional | AS · PA/NP assist | $35.48 | $42.66 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $218.78 | Facility | None | $102.33 | $134.90 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $199.53 Typical High $1,995.26 | Facility | None | $107.15 | $199.53 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $562.34 | Professional | None | $181.97 | $199.53 | $562.34 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $107.15 Median $190.55 Typical High $1,995.26 | Facility | None | $107.15 | $190.55 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $562.34 | Professional | None | $181.97 | $199.53 | $562.34 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $316.23 | Professional | None | $181.97 | $229.09 | $316.23 |
SummaCare Setting Facility Modifier None Typical Low $114.82 Median $120.23 Typical High $134.90 | Facility | None | $114.82 | $120.23 | $134.90 |
SummaCare Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | None | $181.97 | $181.97 | $234.42 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $416.87 | Professional | None | $147.91 | $239.88 | $416.87 |
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 $77.62 Median $77.62 Typical High $707.95 | Professional | 52 · Reduced service | $77.62 | $77.62 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $281.84 | Professional | 53 · Discontinued | $30.90 | $30.90 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $1,047.13 | Professional | 54 · Surgery only | $114.82 | $114.82 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $208.93 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $141.25 |
Where Ohio sits
The same service costs 4.1 times more in Alaska than in Maryland. 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· 22nd of 51
$295
AK $692MD $170
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.