How much rates vary
Facilitymedian $3,467 · 10th to 90th $479 to $16,218Professionalmedian $309 · 10th to 90th $245 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 $302.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $302.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $1,698.24 | Professional | None | $223.87 | $223.87 | $1,698.24 |
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 $245.47 Median $295.12 Typical High $501.19 | Professional | None | $245.47 | $295.12 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $46.77 Typical High $81.28 | Professional | 80 · Assistant surgeon | $38.90 | $46.77 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $39.81 Typical High $70.79 | Professional | AS · PA/NP assist | $33.88 | $39.81 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
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 $269.15 Median $302.00 Typical High $575.44 | Professional | None | $269.15 | $302.00 | $575.44 |
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 $269.15 Median $302.00 Typical High $602.56 | Professional | None | $269.15 | $302.00 | $602.56 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $436.52 | Professional | None | $257.04 | $331.13 | $436.52 |
SummaCare Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $407.38 | Professional | None | $257.04 | $257.04 | $407.38 |
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 $251.19 Median $316.23 Typical High $645.65 | Professional | None | $251.19 | $316.23 | $645.65 |
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 $112.20 Median $112.20 Typical High $776.25 | Professional | 52 · Reduced service | $112.20 | $112.20 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $316.23 | Professional | 53 · Discontinued | $44.67 | $44.67 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $1,174.90 | Professional | 54 · Surgery only | $169.82 | $169.82 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $234.42 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $154.88 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $154.88 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 37th of 51
$347
AK $871TX $275
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.