How much rates vary
Facilitymedian $1,622 · 10th to 90th $447 to $10,965Professionalmedian $3,388 · 10th to 90th $251 to $5,129
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 $3,801.89 Median $10,715.19 Typical High $13,803.84 | Facility | None | $3,801.89 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $12,302.69 | Professional | None | $3,715.35 | $3,801.89 | $12,302.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,398.83 Typical High $9,772.37 | Facility | None | $954.99 | $2,398.83 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $5,495.41 | Professional | None | $3,019.95 | $3,548.13 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $562.34 Typical High $870.96 | Professional | 80 · Assistant surgeon | $478.63 | $562.34 | $870.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $501.19 Typical High $776.25 | Professional | AS · PA/NP assist | $426.58 | $501.19 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $3,467.37 Median $4,265.80 Typical High $7,762.47 | Professional | None | $3,467.37 | $4,265.80 | $7,762.47 |
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 $3,467.37 Median $4,265.80 Typical High $7,762.47 | Professional | None | $3,467.37 | $4,265.80 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $2,884.03 Typical High $4,073.80 | Professional | None | $229.09 | $2,884.03 | $4,073.80 |
SummaCare Setting Professional Modifier None Typical Low $3,311.31 Median $3,630.78 Typical High $6,309.57 | Professional | None | $3,311.31 | $3,630.78 | $6,309.57 |
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 $3,630.78 Median $4,897.79 Typical High $10,232.93 | Professional | None | $3,630.78 | $4,897.79 | $10,232.93 |
4 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 $1,905.46 Median $1,905.46 Typical High $5,495.41 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $2,187.76 | Professional | 53 · Discontinued | $758.58 | $758.58 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $8,317.64 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $8,317.64 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $7,762.47 |
Where Ohio sits
The same service costs 7.6 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
$3,311
AK $13,804AR $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.