How much rates vary
Facilitymedian $1,549 · 10th to 90th $398 to $6,310Professionalmedian $331 · 10th to 90th $43 to $537
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 $398.11 Median $398.11 Typical High $2,630.27 | Professional | None | $398.11 | $398.11 | $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 $275.42 Median $346.74 Typical High $588.84 | Professional | None | $275.42 | $346.74 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $512.86 Typical High $891.25 | Professional | 50 · Both sides | $407.38 | $512.86 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $1,995.26 | Facility | None | $512.86 | $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 $407.38 Median $501.19 Typical High $741.31 | Professional | None | $407.38 | $501.19 | $741.31 |
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 $407.38 Median $501.19 Typical High $707.95 | Professional | None | $407.38 | $501.19 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $269.15 Typical High $478.63 | Professional | None | $33.88 | $269.15 | $478.63 |
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 $363.08 Median $407.38 Typical High $524.81 | Professional | None | $363.08 | $407.38 | $524.81 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $741.31 | Professional | None | $251.19 | $416.87 | $741.31 |
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 $199.53 Median $199.53 Typical High $851.14 | Professional | 52 · Reduced service | $199.53 | $199.53 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $338.84 | Professional | 53 · Discontinued | $79.43 | $79.43 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $1,258.93 | Professional | 54 · Surgery only | $302.00 | $302.00 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $251.19 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $169.82 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $1,174.90 |
Where Ohio sits
The same service costs 8.1 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
$347
AK $1,698TX $209
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.