How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $1,380 · 10th to 90th $174 to $2,042
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 $1,380.38 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,380.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $9,120.11 | Professional | None | $1,380.38 | $1,380.38 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $9,332.54 Typical High $21,877.62 | Facility | None | $1,047.13 | $9,332.54 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $234.42 Typical High $398.11 | Professional | 80 · Assistant surgeon | $190.55 | $234.42 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $338.84 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,513.56 | $2,884.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,479.11 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,148.15 Typical High $1,819.70 | Professional | None | $162.18 | $1,148.15 | $1,819.70 |
SummaCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,348.96 | $2,041.74 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $3,162.28 | Professional | None | $1,258.93 | $1,513.56 | $3,162.28 |
6 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 $691.83 Median $691.83 Typical High $2,238.72 | Professional | 52 · Reduced service | $691.83 | $691.83 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $912.01 | Professional | 53 · Discontinued | $275.42 | $275.42 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $676.08 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $457.09 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $3,162.28 |
Where Ohio sits
The same service costs 7.4 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· 43rd of 51
$1,380
AK $5,623TX $759
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.