How much rates vary
Facilitymedian $2,042 · 10th to 90th $501 to $12,589Professionalmedian $813 · 10th to 90th $646 to $1,413
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $10,232.93 | Professional | None | $812.83 | $812.83 | $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 $645.65 Median $758.58 Typical High $1,174.90 | Professional | None | $645.65 | $758.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $123.03 Typical High $186.21 | Professional | 80 · Assistant surgeon | $102.33 | $123.03 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $165.96 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $2,691.53 | Facility | None | $501.19 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,778.28 | Professional | None | $741.31 | $912.01 | $1,778.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $691.83 Typical High $2,691.53 | Facility | None | $501.19 | $691.83 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,778.28 | Professional | None | $741.31 | $912.01 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $977.24 | Professional | None | $630.96 | $776.25 | $977.24 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,318.26 | Professional | None | $707.95 | $776.25 | $1,318.26 |
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 $776.25 Median $1,096.48 Typical High $2,187.76 | Professional | None | $776.25 | $1,096.48 | $2,187.76 |
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 $407.38 Median $407.38 Typical High $1,174.90 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $467.74 | Professional | 53 · Discontinued | $162.18 | $162.18 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $602.56 | $602.56 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $354.81 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $234.42 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $234.42 |
Where Ohio sits
The same service costs 3.8 times more in Wisconsin 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· 46th of 51
$832
WI $2,951NY $776
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.