How much rates vary
Facilitymedian $1,950 · 10th to 90th $741 to $8,710Professionalmedian $794 · 10th to 90th $162 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 $1,202.26 Median $4,265.80 Typical High $12,589.25 | Facility | None | $1,202.26 | $4,265.80 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $3,715.35 | Professional | None | $588.84 | $707.95 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $8,128.31 | Facility | None | $691.83 | $1,737.80 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,348.96 | Professional | None | $616.60 | $870.96 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,288.25 Typical High $1,995.26 | Professional | 50 · Both sides | $933.25 | $1,288.25 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,479.11 Typical High $1,949.84 | Facility | None | $831.76 | $1,479.11 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,698.24 Typical High $2,951.21 | Facility | None | $741.31 | $1,698.24 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,548.82 | Professional | None | $676.08 | $851.14 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,698.24 Typical High $2,951.21 | Facility | None | $741.31 | $1,698.24 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,584.89 | Professional | None | $645.65 | $851.14 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $707.95 Typical High $1,174.90 | Professional | None | $123.03 | $707.95 | $1,174.90 |
SummaCare Setting Facility Modifier None Typical Low $831.76 Median $870.96 Typical High $977.24 | Facility | None | $831.76 | $870.96 | $977.24 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,148.15 | Professional | None | $616.60 | $891.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,548.82 | Professional | None | $562.34 | $851.14 | $1,548.82 |
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 $295.12 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $436.52 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $87.10 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $407.38 | $501.19 | $549.54 |
Where Ohio sits
The same service costs 3.7 times more in Connecticut than in Arkansas. 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
CT $7,673AR $2,094
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.