How much rates vary
Facilitymedian $1,660 · 10th to 90th $447 to $12,589Professionalmedian $3,388 · 10th to 90th $257 to $5,012
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 $3,715.35 Median $10,715.19 Typical High $13,803.84 | Facility | None | $3,715.35 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,715.35 Typical High $12,589.25 | Professional | None | $3,467.37 | $3,715.35 | $12,589.25 |
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 $2,951.21 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,951.21 | $3,467.37 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $562.34 Typical High $891.25 | Professional | 80 · Assistant surgeon | $467.74 | $562.34 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $489.78 Typical High $741.31 | Professional | AS · PA/NP assist | $416.87 | $489.78 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Facility | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $3,388.44 Median $4,168.69 Typical High $7,585.78 | Professional | None | $3,388.44 | $4,168.69 | $7,585.78 |
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 $3,388.44 Median $4,168.69 Typical High $7,585.78 | Professional | None | $3,388.44 | $4,168.69 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $2,884.03 Typical High $4,073.80 | Professional | None | $234.42 | $2,884.03 | $4,073.80 |
SummaCare Setting Professional Modifier None Typical Low $3,311.31 Median $3,630.78 Typical High $6,165.95 | Professional | None | $3,311.31 | $3,630.78 | $6,165.95 |
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 $3,548.13 Median $4,897.79 Typical High $10,000.00 | Professional | None | $3,548.13 | $4,897.79 | $10,000.00 |
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 $1,862.09 Median $1,862.09 Typical High $6,165.95 | Professional | 52 · Reduced service | $1,862.09 | $1,862.09 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $741.31 Typical High $2,454.71 | Professional | 53 · Discontinued | $741.31 | $741.31 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,818.38 Typical High $9,332.54 | Professional | 54 · Surgery only | $2,818.38 | $2,818.38 | $9,332.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $1,862.09 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $1,230.27 |
Where Ohio sits
The same service costs 7.4 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· 45th of 51
$3,311
AK $13,490AR $1,820
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.