How much rates vary
Facilitymedian $3,162 · 10th to 90th $977 to $10,965Professionalmedian $1,148 · 10th to 90th $135 to $1,698
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 $3,715.35 Median $10,000.00 Typical High $13,803.84 | Facility | None | $3,715.35 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $10,964.78 | Professional | None | $1,174.90 | $1,174.90 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $7,943.28 | Facility | None | $933.25 | $2,238.72 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,862.09 | Professional | None | $977.24 | $1,148.15 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,445.44 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,047.13 | $3,235.94 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,230.27 | $2,089.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,071.52 | $3,235.94 | $5,248.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,230.27 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $1,023.29 Typical High $1,479.11 | Professional | None | $107.15 | $1,023.29 | $1,479.11 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,071.52 | $1,412.54 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,258.93 | $2,630.27 |
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 $588.84 Median $588.84 Typical High $2,041.74 | Professional | 52 · Reduced service | $588.84 | $588.84 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $812.83 | Professional | 53 · Discontinued | $234.42 | $234.42 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $3,019.95 | Professional | 54 · Surgery only | $870.96 | $870.96 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $616.60 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $407.38 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $2,818.38 |
Where Ohio sits
The same service costs 5.5 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· 49th of 51
$1,175
AK $4,786TX $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.