How much rates vary
Facilitymedian $1,413 · 10th to 90th $661 to $8,913Professionalmedian $513 · 10th to 90th $79 to $832
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $5,128.61 | Professional | None | $602.56 | $602.56 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $4,897.79 | Facility | None | $630.96 | $1,258.93 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $891.25 | Professional | None | $407.38 | $512.86 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $776.25 Typical High $1,348.96 | Professional | 50 · Both sides | $616.60 | $776.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $323.59 Typical High $562.34 | Professional | 62 · Two surgeons | $257.04 | $323.59 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,047.13 | Facility | None | $776.25 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $2,951.21 | Facility | None | $691.83 | $977.24 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,122.02 | Professional | None | $630.96 | $776.25 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $977.24 Typical High $2,951.21 | Facility | None | $741.31 | $977.24 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,122.02 | Professional | None | $630.96 | $776.25 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $346.74 Typical High $724.44 | Professional | None | $67.61 | $346.74 | $724.44 |
SummaCare Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Facility | None | $446.68 | $467.74 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $776.25 | Professional | None | $537.03 | $602.56 | $776.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $1,122.02 | Professional | None | $389.05 | $616.60 | $1,122.02 |
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 $302.00 Median $302.00 Typical High $1,412.54 | Professional | 52 · Reduced service | $302.00 | $302.00 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $562.34 | Professional | 53 · Discontinued | $123.03 | $123.03 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $2,089.30 | Professional | 54 · Surgery only | $457.09 | $457.09 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $416.87 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $281.84 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $1,949.84 |
Where Ohio sits
The same service costs 7.2 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· 48th of 51
$513
AK $2,570UT $355
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.