How much rates vary
Facilitymedian $2,042 · 10th to 90th $501 to $12,589Professionalmedian $1,072 · 10th to 90th $851 to $1,905
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 $1,071.52 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,071.52 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $10,232.93 | Professional | None | $1,071.52 | $1,071.52 | $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 $851.14 Median $1,000.00 Typical High $1,548.82 | Professional | None | $851.14 | $1,000.00 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $245.47 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $218.78 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $977.24 Median $1,202.26 Typical High $2,344.23 | Professional | None | $977.24 | $1,202.26 | $2,344.23 |
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 $977.24 Median $1,202.26 Typical High $2,344.23 | Professional | None | $977.24 | $1,202.26 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,318.26 | Professional | None | $851.14 | $1,047.13 | $1,318.26 |
SummaCare Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,778.28 | Professional | None | $933.25 | $1,023.29 | $1,778.28 |
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 $1,023.29 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,479.11 | $2,884.03 |
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 $537.03 Median $537.03 Typical High $1,548.82 | Professional | 52 · Reduced service | $537.03 | $537.03 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $616.60 | Professional | 53 · Discontinued | $213.80 | $213.80 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $2,290.87 | Professional | 54 · Surgery only | $794.33 | $794.33 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $457.09 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $309.03 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $309.03 |
Where Ohio sits
The same service costs 3.7 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· 45th of 51
$1,096
AK $3,802NY $1,023
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.