How much rates vary
Facilitymedian $2,188 · 10th to 90th $759 to $9,120Professionalmedian $871 · 10th to 90th $123 to $1,318
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $9,120.11 | Professional | None | $870.96 | $870.96 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $7,762.47 | Facility | None | $707.95 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | None | $741.31 | $912.01 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $575.44 Typical High $851.14 | Professional | 62 · Two surgeons | $467.74 | $575.44 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $2,454.71 | Facility | None | $1,230.27 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,311.31 | Facility | None | $741.31 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,659.59 | Professional | None | $831.76 | $1,023.29 | $1,659.59 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,311.31 | Facility | None | $741.31 | $2,041.74 | $3,311.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,659.59 | Professional | None | $831.76 | $977.24 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $691.83 Typical High $1,148.15 | Professional | None | $77.62 | $691.83 | $1,148.15 |
SummaCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,000.00 | $1,047.13 | $1,202.26 |
SummaCare Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,202.26 | Professional | None | $933.25 | $933.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,905.46 | Professional | None | $724.44 | $1,000.00 | $1,905.46 |
6 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 $436.52 Median $436.52 Typical High $1,995.26 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $794.33 | Professional | 53 · Discontinued | $173.78 | $173.78 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $2,951.21 | Professional | 54 · Surgery only | $660.69 | $660.69 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $588.84 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $398.11 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $2,754.23 |
Where Ohio sits
The same service costs 8.3 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· 49th of 51
$871
AK $4,074TX $490
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.