How much rates vary
Facilitymedian $1,995 · 10th to 90th $741 to $9,120Professionalmedian $550 · 10th to 90th $91 to $832
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 $1,737.80 Median $8,511.38 Typical High $13,803.84 | Facility | None | $1,737.80 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,621.81 | Professional | None | $588.84 | $588.84 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $501.19 | Professional | None | $257.04 | $257.04 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $7,762.47 | Facility | None | $691.83 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $776.25 | Professional | None | $446.68 | $524.81 | $776.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $331.13 Typical High $489.78 | Professional | 62 · Two surgeons | $281.84 | $331.13 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $2,137.96 | Facility | None | $741.31 | $1,621.81 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,862.09 Typical High $3,162.28 | Facility | None | $741.31 | $1,862.09 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $977.24 | Professional | None | $575.44 | $616.60 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,862.09 Typical High $3,162.28 | Facility | None | $741.31 | $1,862.09 | $3,162.28 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $977.24 | Professional | None | $575.44 | $616.60 | $977.24 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $501.19 Typical High $776.25 | Professional | None | $64.57 | $501.19 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $676.08 | Professional | None | $575.44 | $575.44 | $676.08 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $954.99 | Professional | None | $478.63 | $616.60 | $954.99 |
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 $295.12 Median $295.12 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $114.82 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $537.03 |
Where Ohio sits
The same service costs 4.0 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 $7,771MT $1,932
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.