How much rates vary
Facilitymedian $3,162 · 10th to 90th $933 to $11,482Professionalmedian $741 · 10th to 90th $93 to $1,122
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 $1,412.54 Median $6,760.83 Typical High $15,848.93 | Facility | None | $1,412.54 | $6,760.83 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $9,332.54 | Professional | None | $776.25 | $776.25 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $8,317.64 | Facility | None | $954.99 | $2,630.27 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,174.90 | Professional | None | $616.60 | $724.44 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,096.48 Typical High $1,778.28 | Professional | 50 · Both sides | $933.25 | $1,096.48 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $2,754.23 Typical High $3,630.78 | Facility | None | $933.25 | $2,754.23 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $4,897.79 | Facility | None | $794.33 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,584.89 | Professional | None | $660.69 | $831.76 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $4,570.88 | Facility | None | $794.33 | $3,162.28 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,584.89 | Professional | None | $660.69 | $831.76 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $691.83 Typical High $1,000.00 | Professional | None | $79.43 | $691.83 | $1,000.00 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,096.48 | Professional | None | $691.83 | $691.83 | $1,096.48 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,737.80 | Professional | None | $707.95 | $870.96 | $1,737.80 |
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 $389.05 Median $389.05 Typical High $1,698.24 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $676.08 | Professional | 53 · Discontinued | $154.88 | $154.88 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $2,570.40 | Professional | 54 · Surgery only | $575.44 | $575.44 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $512.86 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $338.84 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $2,398.83 |
Where Ohio sits
The same service costs 7.2 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
$776
OK $3,890UT $537
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.