How much rates vary
Facilitymedian $2,291 · 10th to 90th $741 to $10,000Professionalmedian $501 · 10th to 90th $91 to $776
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $10,232.93 | Professional | None | $537.03 | $537.03 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,318.26 Typical High $4,786.30 | Facility | None | $645.65 | $1,318.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $851.14 | Professional | None | $416.87 | $501.19 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $79.43 Typical High $138.04 | Professional | 80 · Assistant surgeon | $67.61 | $79.43 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $69.18 Typical High $120.23 | Professional | AS · PA/NP assist | $58.88 | $69.18 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $2,818.38 | Facility | None | $676.08 | $2,137.96 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,454.71 Typical High $3,801.89 | Facility | None | $758.58 | $2,454.71 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $1,122.02 | Professional | None | $501.19 | $691.83 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,801.89 | Facility | None | $794.33 | $2,454.71 | $3,801.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $1,122.02 | Professional | None | $501.19 | $691.83 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $467.74 Typical High $676.08 | Professional | None | $79.43 | $467.74 | $676.08 |
SummaCare Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,174.90 | $1,230.27 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $831.76 | Professional | None | $501.19 | $501.19 | $831.76 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,380.38 | Professional | None | $489.78 | $645.65 | $1,380.38 |
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 $269.15 Median $269.15 Typical High $2,238.72 | Professional | 52 · Reduced service | $269.15 | $269.15 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $891.25 | Professional | 53 · Discontinued | $107.15 | $107.15 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $3,388.44 | Professional | 54 · Surgery only | $398.11 | $398.11 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $676.08 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $446.68 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $3,162.28 |
Where Ohio sits
The same service costs 8.3 times more in Oklahoma than in Utah. 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· 49th of 51
$537
OK $2,951UT $355
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.