How much rates vary
Facilitymedian $562 · 10th to 90th $135 to $3,715Professionalmedian $269 · 10th to 90th $204 to $447
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 $501.19 Median $3,235.94 Typical High $12,589.25 | Facility | None | $501.19 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $2,630.27 | Professional | None | $204.17 | $251.19 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,311.31 | Facility | None | $371.54 | $831.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $398.11 | Professional | None | $190.55 | $239.88 | $398.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $120.23 Median $151.36 Typical High $251.19 | Professional | 62 · Two surgeons | $120.23 | $151.36 | $251.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $38.90 Typical High $66.07 | Professional | 80 · Assistant surgeon | $30.90 | $38.90 | $66.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $33.88 Typical High $54.95 | Professional | AS · PA/NP assist | $26.92 | $33.88 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $204.17 | Facility | None | $158.49 | $158.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $302.00 Typical High $1,479.11 | Facility | None | $162.18 | $302.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $512.86 | Professional | None | $213.80 | $288.40 | $512.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $1,479.11 | Facility | None | $162.18 | $288.40 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $524.81 | Professional | None | $213.80 | $288.40 | $524.81 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $436.52 | Professional | None | $208.93 | $323.59 | $436.52 |
SummaCare Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $102.33 | Facility | None | $85.11 | $91.20 | $102.33 |
SummaCare Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $338.84 | Professional | None | $190.55 | $257.04 | $338.84 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $524.81 | Professional | None | $204.17 | $275.42 | $524.81 |
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 $102.33 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $40.74 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $30.90 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $20.42 | $25.12 | $25.12 |
Where Ohio sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 39th of 51
$275
AK $851MD $229
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.