How much rates vary
Facilitymedian $3,467 · 10th to 90th $501 to $11,749Professionalmedian $1,995 · 10th to 90th $209 to $3,020
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 $2,398.83 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,398.83 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $10,232.93 | Professional | None | $2,398.83 | $2,398.83 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $6,025.60 Typical High $12,589.25 | Facility | None | $1,047.13 | $6,025.60 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,513.56 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $239.88 Typical High $467.74 | Professional | 80 · Assistant surgeon | $190.55 | $239.88 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $389.05 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $2,290.87 Typical High $4,265.80 | Professional | None | $2,041.74 | $2,290.87 | $4,265.80 |
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 $2,137.96 Median $2,398.83 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,398.83 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,949.84 Typical High $2,630.27 | Professional | None | $186.21 | $1,949.84 | $2,630.27 |
SummaCare Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,187.76 | $3,890.45 |
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 $1,737.80 Median $2,570.40 Typical High $6,456.54 | Professional | None | $1,737.80 | $2,570.40 | $6,456.54 |
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 $1,202.26 Median $1,202.26 Typical High $3,235.94 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $1,288.25 | Professional | 53 · Discontinued | $478.63 | $478.63 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $4,786.30 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $954.99 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $645.65 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $4,466.84 |
Where Ohio sits
The same service costs 5.8 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· 46th of 51
$2,089
AK $8,710DE $1,514
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.