How much rates vary
Facilitymedian $1,950 · 10th to 90th $661 to $8,318Professionalmedian $1,175 · 10th to 90th $257 to $1,862
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 $1,174.90 Median $4,168.69 Typical High $10,964.78 | Facility | None | $1,174.90 | $4,168.69 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $1,288.25 Typical High $6,606.93 | Professional | None | $426.58 | $1,288.25 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $891.25 Typical High $1,698.24 | Professional | None | $323.59 | $891.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $1,348.96 Typical High $2,570.40 | Professional | 50 · Both sides | $512.86 | $1,348.96 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $1,548.82 Typical High $1,995.26 | Facility | None | $467.74 | $1,548.82 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,884.03 | Facility | None | $549.54 | $1,737.80 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,071.52 Typical High $1,949.84 | Professional | None | $389.05 | $1,071.52 | $1,949.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,884.03 | Facility | None | $602.56 | $1,737.80 | $2,884.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $1,148.15 Typical High $1,949.84 | Professional | None | $389.05 | $1,148.15 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $1,230.27 Typical High $1,698.24 | Professional | None | $141.25 | $1,230.27 | $1,698.24 |
SummaCare Setting Facility Modifier None Typical Low $831.76 Median $870.96 Typical High $1,000.00 | Facility | None | $831.76 | $870.96 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $371.54 Median $1,318.26 Typical High $1,698.24 | Professional | None | $371.54 | $1,318.26 | $1,698.24 |
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 $398.11 Median $1,230.27 Typical High $2,398.83 | Professional | None | $398.11 | $1,230.27 | $2,398.83 |
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 $213.80 Median $645.65 Typical High $812.83 | Professional | 52 · Reduced service | $213.80 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $257.04 Typical High $323.59 | Professional | 53 · Discontinued | $85.11 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $954.99 Typical High $1,230.27 | Professional | 54 · Surgery only | $316.23 | $954.99 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $194.98 Typical High $245.47 | Professional | 55 · Aftercare only | $63.10 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $128.82 Typical High $162.18 | Professional | 56 · Pre-op care only | $42.66 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $891.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $295.12 | $891.25 | $1,148.15 |
Where Ohio sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 41st of 51
$1,230
AK $3,020NE $692
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.