How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $9,120Professionalmedian $550 · 10th to 90th $89 to $912
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 $1,778.28 Median $6,606.93 Typical High $12,589.25 | Facility | None | $1,778.28 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $5,128.61 | Professional | None | $645.65 | $645.65 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $7,762.47 | Facility | None | $691.83 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,148.15 | Professional | None | $549.54 | $676.08 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,023.29 Typical High $1,698.24 | Professional | 50 · Both sides | $812.83 | $1,023.29 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $426.58 Typical High $724.44 | Professional | 62 · Two surgeons | $346.74 | $426.58 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,365.16 | Facility | None | $851.14 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,888.44 | Facility | None | $741.31 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,258.93 | Professional | None | $676.08 | $831.76 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $5,623.41 | Facility | None | $741.31 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,230.27 | Professional | None | $676.08 | $831.76 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $436.52 Typical High $776.25 | Professional | None | $70.79 | $436.52 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $1,230.27 | Professional | None | $416.87 | $741.31 | $1,230.27 |
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 $323.59 Median $323.59 Typical High $1,258.93 | Professional | 52 · Reduced service | $323.59 | $323.59 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $501.19 | Professional | 53 · Discontinued | $128.82 | $128.82 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $1,862.09 | Professional | 54 · Surgery only | $478.63 | $478.63 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $380.19 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $251.19 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $1,737.80 |
Where Ohio sits
The same service costs 4.8 times more in Alaska 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
AK $10,454MT $2,169
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.