How much rates vary
Facilitymedian $2,692 · 10th to 90th $631 to $9,120Professionalmedian $295 · 10th to 90th $42 to $513
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 $1,621.81 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,621.81 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $5,754.40 | Professional | None | $380.19 | $380.19 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $7,585.78 | Facility | None | $602.56 | $1,548.82 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $512.86 | Professional | None | $181.97 | $213.80 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $316.23 Typical High $776.25 | Professional | 50 · Both sides | $269.15 | $316.23 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $3,388.44 Typical High $4,365.16 | Facility | None | $489.78 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,888.44 | Facility | None | $602.56 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $707.95 | Professional | None | $389.05 | $478.63 | $707.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $5,623.41 | Facility | None | $602.56 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $707.95 | Professional | None | $389.05 | $478.63 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $269.15 Typical High $457.09 | Professional | None | $33.88 | $269.15 | $457.09 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $501.19 | Professional | None | $346.74 | $389.05 | $501.19 |
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 $239.88 Median $398.11 Typical High $691.83 | Professional | None | $239.88 | $398.11 | $691.83 |
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 $190.55 Median $190.55 Typical High $660.69 | Professional | 52 · Reduced service | $190.55 | $190.55 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $269.15 | Professional | 53 · Discontinued | $75.86 | $75.86 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $1,000.00 | Professional | 54 · Surgery only | $288.40 | $288.40 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $199.53 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $131.83 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $933.25 |
Where Ohio sits
The same service costs 7.2 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· 49th of 51
$309
AK $1,622TX $224
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.