How much rates vary
Facilitymedian $1,585 · 10th to 90th $562 to $6,166Professionalmedian $372 · 10th to 90th $269 to $550
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 $1,412.54 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,412.54 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $1,318.26 | Professional | None | $371.54 | $371.54 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $4,466.84 | Facility | None | $549.54 | $1,318.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $478.63 | Professional | None | $245.47 | $316.23 | $478.63 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $154.88 Median $199.53 Typical High $309.03 | Professional | 62 · Two surgeons | $154.88 | $199.53 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $1,348.96 Typical High $1,737.80 | Facility | None | $467.74 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | None | $398.11 | $398.11 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,479.11 Typical High $2,290.87 | Facility | None | $489.78 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $616.60 | Professional | None | $363.08 | $389.05 | $616.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $2,187.76 | Facility | None | $512.86 | $1,513.56 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $602.56 | Professional | None | $363.08 | $389.05 | $602.56 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $524.81 | Professional | None | $263.03 | $354.81 | $524.81 |
SummaCare Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $870.96 | Facility | None | $741.31 | $776.25 | $870.96 |
SummaCare Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | None | $380.19 | $380.19 | $446.68 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $602.56 | Professional | None | $302.00 | $389.05 | $602.56 |
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 $186.21 Median $186.21 Typical High $245.47 | Professional | 52 · Reduced service | $186.21 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $48.98 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $338.84 |
Where Ohio sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 43rd of 51
$372
AK $1,549UT $302
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.