How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,000 to $11,482Professionalmedian $617 · 10th to 90th $457 to $1,047
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 $2,511.89 Median $10,000.00 Typical High $13,803.84 | Facility | None | $2,511.89 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,659.59 Typical High $10,964.78 | Professional | None | $645.65 | $1,659.59 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $8,128.31 | Facility | None | $954.99 | $2,290.87 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,000.00 | Professional | None | $512.86 | $602.56 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $380.19 Typical High $630.96 | Professional | 62 · Two surgeons | $323.59 | $380.19 | $630.96 |
Aultcare Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $3,801.89 | Facility | None | $724.44 | $2,884.03 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,318.26 | $3,388.44 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,348.96 | Professional | None | $588.84 | $724.44 | $1,348.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,318.26 | $3,388.44 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,348.96 | Professional | None | $588.84 | $724.44 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $741.31 | Professional | None | $389.05 | $562.34 | $741.31 |
SummaCare Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,949.84 | Facility | None | $1,659.59 | $1,737.80 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,047.13 | Professional | None | $562.34 | $616.60 | $1,047.13 |
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 $630.96 Median $794.33 Typical High $1,737.80 | Professional | None | $630.96 | $794.33 | $1,737.80 |
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 $323.59 Median $323.59 Typical High $1,047.13 | Professional | 52 · Reduced service | $323.59 | $323.59 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $416.87 | Professional | 53 · Discontinued | $128.82 | $128.82 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $1,548.82 | Professional | 54 · Surgery only | $489.78 | $489.78 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $309.03 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $208.93 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $1,445.44 |
Where Ohio sits
The same service costs 5.8 times more in Wisconsin 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
WI $10,507MT $1,825
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.