How much rates vary
Facilitymedian $2,884 · 10th to 90th $708 to $9,550Professionalmedian $661 · 10th to 90th $89 to $1,122
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $5,754.40 | Professional | None | $831.76 | $831.76 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $7,079.46 | Facility | None | $691.83 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,348.96 | Professional | None | $645.65 | $794.33 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,202.26 Typical High $1,995.26 | Professional | 50 · Both sides | $954.99 | $1,202.26 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,047.13 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,884.03 Typical High $4,897.79 | Facility | None | $602.56 | $2,884.03 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,548.82 | Professional | None | $851.14 | $1,096.48 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,884.03 Typical High $4,570.88 | Facility | None | $602.56 | $2,884.03 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,548.82 | Professional | None | $851.14 | $1,096.48 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $537.03 Typical High $933.25 | Professional | None | $70.79 | $537.03 | $933.25 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,047.13 | Professional | None | $724.44 | $812.83 | $1,047.13 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $1,584.89 | Professional | None | $549.54 | $912.01 | $1,584.89 |
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 $407.38 Median $407.38 Typical High $1,445.44 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $575.44 | Professional | 53 · Discontinued | $165.96 | $165.96 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $2,137.96 | Professional | 54 · Surgery only | $616.60 | $616.60 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $426.58 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $288.40 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,995.26 |
Where Ohio sits
The same service costs 20.9 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· 48th of 51
$692
AK $3,467TX $166
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.