How much rates vary
Facilitymedian $1,660 · 10th to 90th $457 to $6,918Professionalmedian $513 · 10th to 90th $89 to $813
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 $1,380.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $2,630.27 | Professional | None | $602.56 | $602.56 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,584.89 Typical High $7,585.78 | Facility | None | $549.54 | $1,584.89 | $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 62 · Two surgeons Typical Low $295.12 Median $371.54 Typical High $602.56 | Professional | 62 · Two surgeons | $295.12 | $371.54 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $1,995.26 | Facility | None | $758.58 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,621.81 Typical High $2,511.89 | Facility | None | $363.08 | $1,621.81 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,096.48 | Professional | None | $588.84 | $724.44 | $1,096.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,621.81 Typical High $2,454.71 | Facility | None | $389.05 | $1,621.81 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,071.52 | Professional | None | $588.84 | $724.44 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $426.58 Typical High $724.44 | Professional | None | $70.79 | $426.58 | $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 $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $1,071.52 | Professional | None | $371.54 | $616.60 | $1,071.52 |
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 $302.00 Median $302.00 Typical High $1,071.52 | Professional | 52 · Reduced service | $302.00 | $302.00 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $426.58 | Professional | 53 · Discontinued | $120.23 | $120.23 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $1,621.81 | Professional | 54 · Surgery only | $446.68 | $446.68 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $323.59 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $213.80 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $1,513.56 |
Where Ohio sits
The same service costs 5.0 times more in Colorado than in Delaware. 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
CO $6,515DE $1,300
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.