How much rates vary
Facilitymedian $1,514 · 10th to 90th $447 to $10,715Professionalmedian $1,660 · 10th to 90th $1,349 to $3,236
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 $1,659.59 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,659.59 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $10,232.93 | Professional | None | $1,659.59 | $1,659.59 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $2,398.83 Typical High $9,772.37 | Facility | None | $933.25 | $2,398.83 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,584.89 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $251.19 Typical High $416.87 | Professional | 80 · Assistant surgeon | $213.80 | $251.19 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $354.81 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,412.54 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,737.80 | $3,019.95 |
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 $1,412.54 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,778.28 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,412.54 | Professional | None | $977.24 | $1,202.26 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,380.38 | $2,511.89 |
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 $1,380.38 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,380.38 | $1,995.26 | $3,890.45 |
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 $831.76 Median $831.76 Typical High $2,238.72 | Professional | 52 · Reduced service | $831.76 | $831.76 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $891.25 | Professional | 53 · Discontinued | $331.13 | $331.13 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $676.08 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $446.68 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $446.68 |
Where Ohio sits
The same service costs 4.7 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· 44th of 51
$1,660
AK $6,166AR $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.