How much rates vary
Facilitymedian $1,950 · 10th to 90th $661 to $10,233Professionalmedian $537 · 10th to 90th $81 to $871
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 $794.33 Median $10,232.93 Typical High $13,803.84 | Facility | None | $794.33 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $2,691.53 | Professional | None | $630.96 | $630.96 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $512.86 Median $630.96 Typical High $1,047.13 | Professional | None | $512.86 | $630.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $954.99 Typical High $1,584.89 | Professional | 50 · Both sides | $758.58 | $954.99 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $398.11 Typical High $660.69 | Professional | 62 · Two surgeons | $323.59 | $398.11 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,548.82 | Facility | None | $794.33 | $1,023.29 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $2,691.53 | Facility | None | $588.84 | $1,778.28 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,230.27 | Professional | None | $660.69 | $831.76 | $1,230.27 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $2,691.53 | Facility | None | $588.84 | $1,778.28 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,230.27 | Professional | None | $660.69 | $831.76 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $436.52 Typical High $724.44 | Professional | None | $70.79 | $436.52 | $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 $588.84 Median $616.60 Typical High $933.25 | Professional | None | $588.84 | $616.60 | $933.25 |
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 $407.38 Median $707.95 Typical High $1,202.26 | Professional | None | $407.38 | $707.95 | $1,202.26 |
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 $316.23 Median $316.23 Typical High $1,258.93 | Professional | 52 · Reduced service | $316.23 | $316.23 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $501.19 | Professional | 53 · Discontinued | $125.89 | $125.89 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $1,905.46 | Professional | 54 · Surgery only | $467.74 | $467.74 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $380.19 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $251.19 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $1,778.28 |
Where Ohio sits
The same service costs 7.6 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.