How much rates vary
Facilitymedian $4,571 · 10th to 90th $676 to $16,596Professionalmedian $912 · 10th to 90th $93 to $1,349
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 $2,454.71 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,454.71 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $9,120.11 | Professional | None | $912.01 | $912.01 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $19,952.62 | Facility | None | $1,047.13 | $7,943.28 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,412.54 | Professional | None | $707.95 | $831.76 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $2,041.74 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $524.81 Typical High $870.96 | Professional | 62 · Two surgeons | $446.68 | $524.81 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $1,230.27 | Facility | None | $630.96 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,862.09 | Professional | None | $812.83 | $1,000.00 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,862.09 | Professional | None | $812.83 | $1,000.00 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,230.27 | Professional | None | $79.43 | $870.96 | $1,230.27 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,318.26 | Professional | None | $851.14 | $851.14 | $1,318.26 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $5,888.44 | Facility | None | $691.83 | $1,348.96 | $5,888.44 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,238.72 | Professional | None | $891.25 | $1,071.52 | $2,238.72 |
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 $457.09 Median $457.09 Typical High $1,737.80 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $691.83 | Professional | 53 · Discontinued | $186.21 | $186.21 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,630.27 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $524.81 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $346.74 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $2,454.71 |
Where Ohio sits
The same service costs 5.6 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· 47th of 51
$933
AK $3,715UT $661
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.