How much rates vary
Facilitymedian $1,862 · 10th to 90th $617 to $7,762Professionalmedian $417 · 10th to 90th $269 to $646
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 $1,778.28 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,778.28 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $9,120.11 | Professional | None | $416.87 | $416.87 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,230.27 Typical High $4,786.30 | Facility | None | $562.34 | $1,230.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $645.65 | Professional | None | $323.59 | $380.19 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $575.44 Typical High $954.99 | Professional | 50 · Both sides | $489.78 | $575.44 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $1,584.89 Typical High $2,089.30 | Facility | None | $501.19 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,754.23 | Facility | None | $602.56 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $831.76 | Professional | None | $371.54 | $436.52 | $831.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,691.53 | Facility | None | $602.56 | $1,819.70 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $851.14 | Professional | None | $371.54 | $436.52 | $851.14 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $398.11 Typical High $562.34 | Professional | None | $47.86 | $398.11 | $562.34 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | None | $389.05 | $389.05 | $575.44 |
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 $371.54 Median $457.09 Typical High $933.25 | Professional | None | $371.54 | $457.09 | $933.25 |
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 $208.93 Median $208.93 Typical High $707.95 | Professional | 52 · Reduced service | $208.93 | $208.93 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $281.84 | Professional | 53 · Discontinued | $83.18 | $83.18 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,047.13 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $213.80 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $141.25 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $977.24 |
Where Ohio sits
The same service costs 6.0 times more in Oklahoma 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· 48th of 51
$437
OK $1,862UT $309
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.