How much rates vary
Facilitymedian $4,169 · 10th to 90th $912 to $10,965Professionalmedian $1,318 · 10th to 90th $214 to $2,188
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 $5,888.44 Typical High $12,022.64 | Facility | None | $2,691.53 | $5,888.44 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $8,912.51 | Professional | None | $1,621.81 | $1,621.81 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,096.48 | $3,548.13 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,621.81 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,454.71 Typical High $3,981.07 | Professional | 50 · Both sides | $1,949.84 | $2,454.71 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $4,365.16 | Facility | None | $2,041.74 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,890.45 Typical High $6,606.93 | Facility | None | $549.54 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,137.96 | $3,019.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,890.45 Typical High $6,606.93 | Facility | None | $549.54 | $3,890.45 | $6,606.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,659.59 | $2,137.96 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,023.29 Typical High $1,778.28 | Professional | None | $177.83 | $1,023.29 | $1,778.28 |
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 $1,380.38 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,548.82 | $1,995.26 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,047.13 | $1,778.28 | $3,090.30 |
4 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 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $6,309.57 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $1,258.93 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $831.76 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $5,888.44 |
Where Ohio sits
The same service costs 7.8 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· 48th of 51
$1,318
AK $6,761TX $871
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.