How much rates vary
Facilitymedian $2,570 · 10th to 90th $661 to $10,965Professionalmedian $302 · 10th to 90th $170 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 $1,737.80 Median $3,467.37 Typical High $12,589.25 | Facility | None | $1,737.80 | $3,467.37 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $2,630.27 | Professional | None | $537.03 | $537.03 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $3,630.78 Typical High $18,620.87 | Facility | None | $691.83 | $3,630.78 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $346.74 | Professional | None | $169.82 | $213.80 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $316.23 Typical High $512.86 | Professional | 50 · Both sides | $251.19 | $316.23 | $512.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $107.15 Median $131.83 Typical High $218.78 | Professional | 62 · Two surgeons | $107.15 | $131.83 | $218.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $33.88 Typical High $169.82 | Professional | 80 · Assistant surgeon | $26.92 | $33.88 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $29.51 Typical High $48.98 | Professional | AS · PA/NP assist | $23.44 | $29.51 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,621.81 Typical High $6,760.83 | Facility | None | $524.81 | $1,621.81 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,071.52 | Professional | None | $616.60 | $776.25 | $1,071.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $6,760.83 | Facility | None | $524.81 | $1,659.59 | $6,760.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,071.52 | Professional | None | $616.60 | $776.25 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $323.59 | Professional | None | $158.49 | $234.42 | $323.59 |
SummaCare Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $380.19 | Professional | None | $263.03 | $295.12 | $380.19 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,905.46 Typical High $8,912.51 | Facility | None | $691.83 | $1,905.46 | $8,912.51 |
United Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $537.03 | Professional | None | $177.83 | $309.03 | $537.03 |
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 $269.15 Median $269.15 Typical High $933.25 | Professional | 52 · Reduced service | $269.15 | $269.15 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $380.19 | Professional | 53 · Discontinued | $107.15 | $107.15 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $1,412.54 | Professional | 54 · Surgery only | $407.38 | $407.38 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $281.84 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $190.55 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $190.55 |
Where Ohio sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 47th of 51
$355
AK $2,455KY $245
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.