How much rates vary
Facilitymedian $1,380 · 10th to 90th $575 to $6,166Professionalmedian $955 · 10th to 90th $93 to $1,445
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 $1,949.84 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,949.84 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $5,011.87 | Professional | None | $1,000.00 | $1,000.00 | $5,011.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $4,570.88 | Facility | None | $537.03 | $1,258.93 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,479.11 | Professional | None | $741.31 | $870.96 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $562.34 Typical High $933.25 | Professional | 62 · Two surgeons | $467.74 | $562.34 | $933.25 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $831.76 Typical High $1,258.93 | Facility | None | $562.34 | $831.76 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $2,398.83 | Facility | None | $537.03 | $1,071.52 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $2,041.74 | Professional | None | $891.25 | $1,096.48 | $2,041.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,071.52 Typical High $2,398.83 | Facility | None | $549.54 | $1,071.52 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $2,041.74 | Professional | None | $891.25 | $1,096.48 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $870.96 Typical High $1,318.26 | Professional | None | $81.28 | $870.96 | $1,318.26 |
SummaCare Setting Facility Modifier None Typical Low $512.86 Median $537.03 Typical High $616.60 | Facility | None | $512.86 | $537.03 | $616.60 |
SummaCare Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,479.11 | Professional | None | $933.25 | $933.25 | $1,479.11 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,454.71 | Professional | None | $954.99 | $1,174.90 | $2,454.71 |
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 $501.19 Median $501.19 Typical High $1,905.46 | Professional | 52 · Reduced service | $501.19 | $501.19 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $758.58 | Professional | 53 · Discontinued | $204.17 | $204.17 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $2,884.03 | Professional | 54 · Surgery only | $758.58 | $758.58 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $575.44 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $380.19 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $2,691.53 |
Where Ohio sits
The same service costs 5.9 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· 46th of 51
$977
AK $4,074UT $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.