How much rates vary
Facilitymedian $3,467 · 10th to 90th $575 to $16,218Professionalmedian $339 · 10th to 90th $229 to $525
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 $1,479.11 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,479.11 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $4,365.16 | Professional | None | $331.13 | $338.84 | $4,365.16 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $19,498.45 | Facility | None | $1,047.13 | $7,943.28 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $616.60 | Professional | None | $269.15 | $323.59 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $52.48 Typical High $97.72 | Professional | 80 · Assistant surgeon | $43.65 | $52.48 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $45.71 Typical High $87.10 | Professional | AS · PA/NP assist | $38.02 | $45.71 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $691.83 | Professional | None | $323.59 | $426.58 | $691.83 |
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 $323.59 Median $426.58 Typical High $691.83 | Professional | None | $323.59 | $426.58 | $691.83 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $323.59 Typical High $446.68 | Professional | None | $57.54 | $323.59 | $446.68 |
SummaCare Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $616.60 | Professional | None | $309.03 | $323.59 | $616.60 |
United Setting Facility Modifier None Typical Low $501.19 Median $891.25 Typical High $4,677.35 | Facility | None | $501.19 | $891.25 | $4,677.35 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $831.76 | Professional | None | $302.00 | $389.05 | $831.76 |
7 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 $165.96 Median $165.96 Typical High $660.69 | Professional | 52 · Reduced service | $165.96 | $165.96 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $263.03 | Professional | 53 · Discontinued | $66.07 | $66.07 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $1,000.00 | Professional | 54 · Surgery only | $245.47 | $245.47 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $199.53 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $131.83 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $933.25 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 59 · Distinct service | $354.81 | $354.81 | $354.81 |
Where Ohio sits
The same service costs 5.8 times more in Alaska 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· 46th of 51
$355
AK $1,380UT $240
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.