How much rates vary
Facilitymedian $1,862 · 10th to 90th $447 to $12,589Professionalmedian $1,995 · 10th to 90th $209 to $3,162
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 $2,238.72 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,238.72 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $10,232.93 | Professional | None | $2,238.72 | $2,238.72 | $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 $1,445.44 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,862.09 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $295.12 Typical High $512.86 | Professional | 80 · Assistant surgeon | $229.09 | $295.12 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $257.04 Typical High $457.09 | Professional | AS · PA/NP assist | $204.17 | $257.04 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $1,995.26 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,511.89 | $4,466.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,511.89 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,905.46 Typical High $2,570.40 | Professional | None | $186.21 | $1,905.46 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,137.96 | $3,715.35 |
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 $1,995.26 Median $2,570.40 Typical High $6,025.60 | Professional | None | $1,995.26 | $2,570.40 | $6,025.60 |
6 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 $1,122.02 Median $1,122.02 Typical High $3,235.94 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $1,288.25 | Professional | 53 · Discontinued | $446.68 | $446.68 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $4,786.30 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $954.99 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $645.65 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $4,466.84 |
Where Ohio sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 47th of 51
$1,995
AK $8,128TX $1,549
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.