How much rates vary
Facilitymedian $6,918 · 10th to 90th $891 to $16,982Professionalmedian $447 · 10th to 90th $331 to $813
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 $2,454.71 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,454.71 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $1,258.93 Typical High $11,220.18 | Professional | None | $489.78 | $1,258.93 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $794.33 | Professional | None | $371.54 | $446.68 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $281.84 Typical High $489.78 | Professional | 62 · Two surgeons | $234.42 | $281.84 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $7,079.46 Typical High $9,332.54 | Facility | None | $549.54 | $7,079.46 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $7,762.47 Typical High $15,135.61 | Facility | None | $549.54 | $7,762.47 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $977.24 | Professional | None | $436.52 | $549.54 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $7,762.47 Typical High $15,135.61 | Facility | None | $549.54 | $7,762.47 | $15,135.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $1,023.29 | Professional | None | $436.52 | $549.54 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $549.54 | Professional | None | $275.42 | $407.38 | $549.54 |
SummaCare Setting Facility Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $4,466.84 | Facility | None | $3,715.35 | $3,981.07 | $4,466.84 |
SummaCare Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $776.25 | Professional | None | $416.87 | $446.68 | $776.25 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,570.88 Typical High $22,387.21 | Facility | None | $1,071.52 | $4,570.88 | $22,387.21 |
United Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,318.26 | Professional | None | $467.74 | $588.84 | $1,318.26 |
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 $245.47 Median $245.47 Typical High $851.14 | Professional | 52 · Reduced service | $245.47 | $245.47 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $338.84 | Professional | 53 · Discontinued | $100.00 | $100.00 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $1,288.25 | Professional | 54 · Surgery only | $371.54 | $371.54 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $257.04 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $169.82 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $1,202.26 |
Where Ohio sits
The same service costs 16.2 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $21,968MT $1,353
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.