How much rates vary
Facilitymedian $1,862 · 10th to 90th $661 to $8,511Professionalmedian $550 · 10th to 90th $132 to $933
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $2,570.40 | Professional | None | $478.63 | $707.95 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $7,585.78 | Facility | None | $645.65 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $891.25 | Professional | None | $302.00 | $354.81 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $223.87 Typical High $575.44 | Professional | 62 · Two surgeons | $190.55 | $223.87 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,995.26 | Facility | None | $891.25 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,202.26 | Professional | None | $724.44 | $933.25 | $1,202.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,202.26 | Professional | None | $724.44 | $933.25 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $512.86 Typical High $812.83 | Professional | None | $112.20 | $512.86 | $812.83 |
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 $616.60 Median $691.83 Typical High $891.25 | Professional | None | $616.60 | $691.83 | $891.25 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,258.93 | Professional | None | $457.09 | $691.83 | $1,258.93 |
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 $354.81 Median $354.81 Typical High $1,288.25 | Professional | 52 · Reduced service | $354.81 | $354.81 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $512.86 | Professional | 53 · Discontinued | $141.25 | $141.25 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,949.84 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $389.05 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $257.04 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,819.70 |
Where Ohio sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 49th of 51
$575
AK $2,951UT $447
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.