How much rates vary
Facilitymedian $3,715 · 10th to 90th $741 to $10,471Professionalmedian $550 · 10th to 90th $437 to $912
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 $1,949.84 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,949.84 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $7,943.28 | Professional | None | $467.74 | $467.74 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,630.27 Typical High $7,762.47 | Facility | None | $831.76 | $2,630.27 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $831.76 | Professional | None | $407.38 | $512.86 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $81.28 Typical High $134.90 | Professional | 80 · Assistant surgeon | $66.07 | $81.28 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $70.79 Typical High $117.49 | Professional | AS · PA/NP assist | $57.54 | $70.79 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,897.79 Typical High $8,317.64 | Facility | None | $549.54 | $4,897.79 | $8,317.64 |
Cigna 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 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,897.79 Typical High $7,762.47 | Facility | None | $549.54 | $4,897.79 | $7,762.47 |
Medical Mutual of Ohio 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 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $776.25 | Professional | None | $446.68 | $575.44 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $3,162.28 | Facility | None | $2,630.27 | $2,754.23 | $3,162.28 |
SummaCare Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $707.95 | Professional | None | $457.09 | $457.09 | $707.95 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $1,096.48 | Professional | None | $436.52 | $549.54 | $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 $234.42 Median $234.42 Typical High $933.25 | Professional | 52 · Reduced service | $234.42 | $234.42 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $371.54 | Professional | 53 · Discontinued | $93.33 | $93.33 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $1,380.38 | Professional | 54 · Surgery only | $354.81 | $354.81 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $281.84 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $186.21 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $186.21 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in New York. 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· 41st of 51
$603
AK $1,905NY $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.