How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $12,589Professionalmedian $1,660 · 10th to 90th $1,202 to $2,754
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 $1,737.80 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,737.80 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $10,232.93 | Professional | None | $1,737.80 | $1,737.80 | $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 $1,023.29 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,318.26 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $208.93 Typical High $380.19 | Professional | 80 · Assistant surgeon | $162.18 | $208.93 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $181.97 Typical High $331.13 | Professional | AS · PA/NP assist | $141.25 | $181.97 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,548.82 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,949.84 | $3,235.94 |
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 $1,548.82 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,949.84 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,698.24 | $2,089.30 |
SummaCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,659.59 | $2,818.38 |
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 $1,412.54 Median $1,949.84 Typical High $4,677.35 | Professional | None | $1,412.54 | $1,949.84 | $4,677.35 |
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 $870.96 Median $870.96 Typical High $2,511.89 | Professional | 52 · Reduced service | $870.96 | $870.96 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $1,000.00 | Professional | 53 · Discontinued | $346.74 | $346.74 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $741.31 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $501.19 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $501.19 |
Where Ohio sits
The same service costs 4.7 times more in Alaska than in Delaware. 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· 44th of 51
$1,660
AK $6,166DE $1,318
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.