How much rates vary
Facilitymedian $741 · 10th to 90th $263 to $4,266Professionalmedian $282 · 10th to 90th $51 to $501
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 $457.09 Median $1,202.26 Typical High $10,715.19 | Facility | None | $457.09 | $1,202.26 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $1,096.48 | Professional | None | $251.19 | $354.81 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $389.05 | Professional | None | $190.55 | $239.88 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $323.59 | Facility | None | $245.47 | $316.23 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $309.03 Typical High $602.56 | Facility | None | $58.88 | $309.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $575.44 | Professional | None | $257.04 | $354.81 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $302.00 Typical High $602.56 | Facility | None | $58.88 | $302.00 | $602.56 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $575.44 | Professional | None | $257.04 | $354.81 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $251.19 Typical High $467.74 | Professional | None | $33.88 | $251.19 | $467.74 |
SummaCare Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $173.78 | Facility | None | $144.54 | $151.36 | $173.78 |
SummaCare Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $467.74 | Professional | None | $251.19 | $380.19 | $467.74 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $549.54 | Professional | None | $190.55 | $309.03 | $549.54 |
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 $125.89 Median $177.83 Typical High $186.21 | Professional | 52 · Reduced service | $125.89 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $70.79 Typical High $74.13 | Professional | 53 · Discontinued | $50.12 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $263.03 Typical High $275.42 | Professional | 54 · Surgery only | $186.21 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $35.48 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.12 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $245.47 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $173.78 | $245.47 | $257.04 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $38.02 Typical High $190.55 | Professional | 80 · Assistant surgeon | $30.90 | $38.02 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $33.88 Typical High $54.95 | Professional | AS · PA/NP assist | $26.92 | $33.88 | $54.95 |
Where Ohio sits
The same service costs 4.5 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
$295
AK $1,072TX $240
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.