How much rates vary
Facilitymedian $2,399 · 10th to 90th $692 to $10,965Professionalmedian $603 · 10th to 90th $89 to $955
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $6,456.54 | Professional | None | $707.95 | $707.95 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,122.02 | Professional | None | $562.34 | $707.95 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,047.13 Typical High $1,659.59 | Professional | 50 · Both sides | $851.14 | $1,047.13 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $691.83 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,238.72 Typical High $3,467.37 | Facility | None | $588.84 | $2,238.72 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,230.27 | Professional | None | $724.44 | $912.01 | $1,230.27 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $2,238.72 Typical High $3,311.31 | Facility | None | $588.84 | $2,238.72 | $3,311.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,230.27 | Professional | None | $724.44 | $912.01 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $478.63 Typical High $831.76 | Professional | None | $70.79 | $478.63 | $831.76 |
SummaCare Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,288.25 | Facility | None | $1,071.52 | $1,122.02 | $1,288.25 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $891.25 | Professional | None | $616.60 | $691.83 | $891.25 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $10,471.29 | Facility | None | $912.01 | $3,388.44 | $10,471.29 |
United Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $1,288.25 | Professional | None | $446.68 | $741.31 | $1,288.25 |
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 $346.74 Median $346.74 Typical High $2,137.96 | Professional | 52 · Reduced service | $346.74 | $346.74 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $851.14 | Professional | 53 · Discontinued | $141.25 | $141.25 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $3,162.28 | Professional | 54 · Surgery only | $524.81 | $524.81 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $630.96 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $426.58 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $2,951.21 |
Where Ohio sits
The same service costs 7.6 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
$617
AK $2,951TX $389
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.