How much rates vary
Facilitymedian $2,692 · 10th to 90th $676 to $9,120Professionalmedian $813 · 10th to 90th $79 to $1,230
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 $1,548.82 Median $6,918.31 Typical High $12,022.64 | Facility | None | $1,548.82 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $7,943.28 | Professional | None | $831.76 | $831.76 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,348.96 | Professional | None | $660.69 | $831.76 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $524.81 Typical High $831.76 | Professional | 62 · Two surgeons | $416.87 | $524.81 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $2,454.71 Typical High $3,162.28 | Facility | None | $1,023.29 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $4,365.16 | Facility | None | $602.56 | $2,691.53 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,698.24 | Professional | None | $741.31 | $912.01 | $1,698.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $4,168.69 | Facility | None | $602.56 | $2,691.53 | $4,168.69 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,698.24 | Professional | None | $741.31 | $912.01 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $776.25 Typical High $1,096.48 | Professional | None | $63.10 | $776.25 | $1,096.48 |
SummaCare Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,412.54 | $1,479.11 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,174.90 | Professional | None | $776.25 | $776.25 | $1,174.90 |
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 $794.33 Median $977.24 Typical High $1,995.26 | Professional | None | $794.33 | $977.24 | $1,995.26 |
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 $416.87 Median $416.87 Typical High $1,380.38 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $562.34 | Professional | 53 · Discontinued | $165.96 | $165.96 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,089.30 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $416.87 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $275.42 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $1,949.84 |
Where Ohio sits
The same service costs 5.9 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· 48th of 51
$832
AK $3,467TX $589
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.