How much rates vary
Facilitymedian $550 · 10th to 90th $100 to $3,715Professionalmedian $251 · 10th to 90th $46 to $447
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 $467.74 Median $954.99 Typical High $10,715.19 | Facility | None | $467.74 | $954.99 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $870.96 | Professional | None | $257.04 | $288.40 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $354.81 | Professional | None | $158.49 | $199.53 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $302.00 Typical High $524.81 | Professional | 50 · Both sides | $239.88 | $302.00 | $524.81 |
Aultcare Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $331.13 | Facility | None | $125.89 | $162.18 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $245.47 | Facility | None | $58.88 | $144.54 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $478.63 | Professional | None | $251.19 | $316.23 | $478.63 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $245.47 | Facility | None | $58.88 | $144.54 | $245.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $478.63 | Professional | None | $251.19 | $316.23 | $478.63 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $169.82 Typical High $426.58 | Professional | None | $32.36 | $169.82 | $426.58 |
SummaCare Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $83.18 | Facility | None | $69.18 | $72.44 | $83.18 |
SummaCare Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $407.38 | Professional | None | $269.15 | $331.13 | $407.38 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $467.74 | Professional | None | $169.82 | $257.04 | $467.74 |
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 $128.82 Median $144.54 Typical High $154.88 | Professional | 52 · Reduced service | $128.82 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $61.66 | Professional | 53 · Discontinued | $51.29 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | 54 · Surgery only | $190.55 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $30.90 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $213.80 |
Where Ohio sits
The same service costs 5.4 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· 46th of 51
$257
AK $1,096TX $204
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.