How much rates vary
Facilitymedian $2,239 · 10th to 90th $661 to $10,233Professionalmedian $427 · 10th to 90th $83 to $692
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 $1,905.46 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,905.46 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $5,754.40 | Professional | None | $524.81 | $524.81 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $7,762.47 | Facility | None | $630.96 | $1,862.09 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $741.31 | Professional | None | $380.19 | $489.78 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $741.31 Typical High $1,122.02 | Professional | 50 · Both sides | $575.44 | $741.31 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $1,995.26 | Facility | None | $676.08 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,691.53 | Facility | None | $549.54 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $977.24 | Professional | None | $537.03 | $676.08 | $977.24 |
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 $537.03 Median $676.08 Typical High $954.99 | Professional | None | $537.03 | $676.08 | $954.99 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $338.84 Typical High $588.84 | Professional | None | $70.79 | $338.84 | $588.84 |
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 $478.63 Median $524.81 Typical High $691.83 | Professional | None | $478.63 | $524.81 | $691.83 |
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 $331.13 Median $562.34 Typical High $977.24 | Professional | None | $331.13 | $562.34 | $977.24 |
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 $263.03 Median $263.03 Typical High $891.25 | Professional | 52 · Reduced service | $263.03 | $263.03 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $354.81 | Professional | 53 · Discontinued | $104.71 | $104.71 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $1,348.96 | Professional | 54 · Surgery only | $398.11 | $398.11 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $269.15 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $177.83 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $1,258.93 |
Where Ohio sits
The same service costs 7.9 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
$447
AK $2,239TX $282
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.