How much rates vary
Facilitymedian $1,995 · 10th to 90th $851 to $10,715Professionalmedian $417 · 10th to 90th $79 to $646
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 $10,000.00 Typical High $13,803.84 | Facility | None | $2,398.83 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $8,317.64 | Professional | None | $446.68 | $446.68 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $7,762.47 | Facility | None | $812.83 | $1,819.70 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $741.31 | Professional | None | $338.84 | $426.58 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $630.96 Typical High $1,096.48 | Professional | 50 · Both sides | $512.86 | $630.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $213.80 Median $269.15 Typical High $467.74 | Professional | 62 · Two surgeons | $213.80 | $269.15 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $1,513.56 Typical High $1,995.26 | Facility | None | $575.44 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $4,677.35 | Facility | None | $1,071.52 | $1,778.28 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $831.76 | Professional | None | $457.09 | $575.44 | $831.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $4,677.35 | Facility | None | $1,096.48 | $1,778.28 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $831.76 | Professional | None | $457.09 | $575.44 | $831.76 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $338.84 Typical High $562.34 | Professional | None | $67.61 | $338.84 | $562.34 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $588.84 | Professional | None | $407.38 | $446.68 | $588.84 |
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 $281.84 Median $478.63 Typical High $812.83 | Professional | None | $281.84 | $478.63 | $812.83 |
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 $223.87 Median $223.87 Typical High $758.58 | Professional | 52 · Reduced service | $223.87 | $223.87 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $309.03 | Professional | 53 · Discontinued | $89.13 | $89.13 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $1,148.15 | Professional | 54 · Surgery only | $338.84 | $338.84 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $229.09 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $151.36 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $1,071.52 |
Where Ohio sits
The same service costs 5.1 times more in Washington, DC than in Montana. 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
DC $7,757MT $1,518
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.