How much rates vary
Facilitymedian $1,514 · 10th to 90th $447 to $10,965Professionalmedian $3,631 · 10th to 90th $2,042 to $5,888
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 $2,630.27 Median $10,715.19 Typical High $13,803.84 | Facility | None | $2,630.27 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $12,882.50 | Professional | None | $2,630.27 | $2,630.27 | $12,882.50 |
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 $3,090.30 Median $3,630.78 Typical High $5,888.44 | Professional | None | $3,090.30 | $3,630.78 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $588.84 Typical High $954.99 | Professional | 80 · Assistant surgeon | $501.19 | $588.84 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $512.86 Typical High $831.76 | Professional | AS · PA/NP assist | $436.52 | $512.86 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $2,041.74 Median $2,454.71 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,454.71 | $4,677.35 |
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 $2,041.74 Median $2,454.71 Typical High $4,897.79 | Professional | None | $2,041.74 | $2,454.71 | $4,897.79 |
SummaCare Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,698.24 | $3,090.30 |
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 $1,698.24 Median $2,290.87 Typical High $4,786.30 | Professional | None | $1,698.24 | $2,290.87 | $4,786.30 |
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 $1,288.25 Median $1,288.25 Typical High $5,754.40 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $2,290.87 | Professional | 53 · Discontinued | $524.81 | $524.81 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $8,709.64 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $8,709.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $1,737.80 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $1,148.15 |
Where Ohio sits
The same service costs 5.6 times more in Alaska than in South Carolina. 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· 28th of 51
$3,090
AK $9,550SC $1,698
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.