How much rates vary
Facilitymedian $1,660 · 10th to 90th $447 to $12,589Professionalmedian $1,622 · 10th to 90th $1,259 to $2,884
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 $1,479.11 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,479.11 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $10,232.93 | Professional | None | $1,479.11 | $1,479.11 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,621.81 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $263.03 Typical High $426.58 | Professional | 80 · Assistant surgeon | $213.80 | $263.03 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $229.09 Typical High $346.74 | Professional | AS · PA/NP assist | $186.21 | $229.09 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,801.89 | Professional | None | $1,348.96 | $1,659.59 | $3,801.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,801.89 | Professional | None | $1,348.96 | $1,659.59 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,445.44 | $1,819.70 |
SummaCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,445.44 | $2,570.40 |
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 $1,445.44 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,445.44 | $2,238.72 | $3,981.07 |
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 $741.31 Median $741.31 Typical High $2,454.71 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $977.24 | Professional | 53 · Discontinued | $302.00 | $302.00 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $741.31 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $489.78 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $489.78 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in Arkansas. 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· 46th of 51
$1,622
AK $5,370AR $1,380
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.