How much rates vary
Facilitymedian $2,884 · 10th to 90th $646 to $9,550Professionalmedian $562 · 10th to 90th $107 to $1,047
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 $1,202.26 Median $3,467.37 Typical High $11,220.18 | Facility | None | $1,202.26 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $5,128.61 | Professional | None | $660.69 | $912.01 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,454.71 Typical High $11,220.18 | Facility | None | $707.95 | $2,454.71 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $870.96 | Professional | None | $331.13 | $407.38 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $616.60 Typical High $1,348.96 | Professional | 50 · Both sides | $467.74 | $616.60 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $208.93 Median $257.04 Typical High $549.54 | Professional | 62 · Two surgeons | $208.93 | $257.04 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $2,570.40 Typical High $3,388.44 | Facility | None | $933.25 | $2,570.40 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,951.21 Typical High $4,786.30 | Facility | None | $489.78 | $2,951.21 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,862.09 | Professional | None | $562.34 | $1,000.00 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $3,019.95 Typical High $4,786.30 | Facility | None | $512.86 | $3,019.95 | $4,786.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,862.09 | Professional | None | $676.08 | $1,000.00 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $562.34 Typical High $933.25 | Professional | None | $83.18 | $562.34 | $933.25 |
SummaCare Setting Facility Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,621.81 | $1,698.24 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,230.27 | Professional | None | $707.95 | $707.95 | $1,230.27 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $10,232.93 | Facility | None | $851.14 | $2,754.23 | $10,232.93 |
United Setting Professional Modifier None Typical Low $316.23 Median $1,000.00 Typical High $2,041.74 | Professional | None | $316.23 | $1,000.00 | $2,041.74 |
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 $331.13 Median $331.13 Typical High $2,570.40 | Professional | 52 · Reduced service | $331.13 | $331.13 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $1,023.29 | Professional | 53 · Discontinued | $131.83 | $131.83 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $3,801.89 | Professional | 54 · Surgery only | $489.78 | $489.78 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $776.25 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $512.86 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $3,548.13 |
Where Ohio sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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.
Physician feeFacility fee
CO $12,924HI $2,150
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.