How much rates vary
Facilitymedian $1,862 · 10th to 90th $603 to $8,318Professionalmedian $513 · 10th to 90th $79 to $851
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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $3,548.13 | Professional | None | $616.60 | $616.60 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $7,585.78 | Facility | None | $588.84 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $954.99 | Professional | None | $467.74 | $588.84 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $870.96 Typical High $1,445.44 | Professional | 50 · Both sides | $691.83 | $870.96 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $1,995.26 | Facility | None | $794.33 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $2,511.89 | Facility | None | $489.78 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,148.15 | Professional | None | $630.96 | $794.33 | $1,148.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $2,454.71 | Facility | None | $512.86 | $1,737.80 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,122.02 | Professional | None | $630.96 | $794.33 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $346.74 Typical High $724.44 | Professional | None | $67.61 | $346.74 | $724.44 |
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 $549.54 Median $602.56 Typical High $794.33 | Professional | None | $549.54 | $602.56 | $794.33 |
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 $398.11 Median $660.69 Typical High $1,122.02 | Professional | None | $398.11 | $660.69 | $1,122.02 |
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 $309.03 Median $309.03 Typical High $1,047.13 | Professional | 52 · Reduced service | $309.03 | $309.03 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $426.58 | Professional | 53 · Discontinued | $123.03 | $123.03 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $1,584.89 | Professional | 54 · Surgery only | $467.74 | $467.74 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $316.23 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $213.80 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $1,479.11 |
Where Ohio sits
The same service costs 18.6 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· 47th of 51
$537
AK $2,630TX $141
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.