How much rates vary
Facilitymedian $2,399 · 10th to 90th $513 to $7,762Professionalmedian $525 · 10th to 90th $407 to $813
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 $549.54 Median $10,232.93 Typical High $13,803.84 | Facility | None | $549.54 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $9,120.11 | Professional | None | $426.58 | $426.58 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $6,309.57 | Facility | None | $741.31 | $3,311.31 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $741.31 | Professional | None | $389.05 | $457.09 | $741.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $288.40 Typical High $467.74 | Professional | 62 · Two surgeons | $245.47 | $288.40 | $467.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $74.13 Typical High $123.03 | Professional | 80 · Assistant surgeon | $63.10 | $74.13 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $64.57 Typical High $104.71 | Professional | AS · PA/NP assist | $54.95 | $64.57 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $977.24 | Professional | None | $467.74 | $616.60 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,000.00 | Professional | None | $467.74 | $616.60 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $724.44 | Professional | None | $416.87 | $537.03 | $724.44 |
SummaCare Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $602.56 | Professional | None | $446.68 | $446.68 | $602.56 |
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 $416.87 Median $616.60 Typical High $1,148.15 | Professional | None | $416.87 | $616.60 | $1,148.15 |
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 $213.80 Median $213.80 Typical High $691.83 | Professional | 52 · Reduced service | $213.80 | $213.80 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $275.42 | Professional | 53 · Discontinued | $85.11 | $85.11 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,047.13 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $208.93 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $138.04 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $138.04 |
Where Ohio sits
The same service costs 4.3 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· 37th of 51
$562
AK $1,905UT $447
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.