How much rates vary
Facilitymedian $2,884 · 10th to 90th $794 to $10,233Professionalmedian $407 · 10th to 90th $81 to $676
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 $2,398.83 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,398.83 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $9,120.11 | Professional | None | $467.74 | $467.74 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $7,762.47 | Facility | None | $794.33 | $2,238.72 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $1,258.93 | Professional | None | $407.38 | $512.86 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $323.59 Typical High $794.33 | Professional | 62 · Two surgeons | $257.04 | $323.59 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $3,630.78 Typical High $4,677.35 | Facility | None | $602.56 | $3,630.78 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $4,897.79 | Facility | None | $794.33 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $977.24 | Professional | None | $489.78 | $630.96 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $3,162.28 Typical High $4,570.88 | Facility | None | $851.14 | $3,162.28 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $977.24 | Professional | None | $489.78 | $630.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $323.59 Typical High $537.03 | Professional | None | $70.79 | $323.59 | $537.03 |
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 $416.87 Median $457.09 Typical High $602.56 | Professional | None | $416.87 | $457.09 | $602.56 |
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 $316.23 Median $549.54 Typical High $933.25 | Professional | None | $316.23 | $549.54 | $933.25 |
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 $234.42 Median $234.42 Typical High $977.24 | Professional | 52 · Reduced service | $234.42 | $234.42 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $398.11 | Professional | 53 · Discontinued | $93.33 | $93.33 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $1,479.11 | Professional | 54 · Surgery only | $354.81 | $354.81 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $295.12 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $199.53 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $1,380.38 |
Where Ohio sits
The same service costs 18.2 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
$417
AK $1,995TX $110
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.