How much rates vary
Facilitymedian $1,585 · 10th to 90th $575 to $7,762Professionalmedian $398 · 10th to 90th $224 to $692
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 $407.38 Median $1,380.38 Typical High $10,964.78 | Facility | None | $407.38 | $1,380.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $1,513.56 | Professional | None | $213.80 | $407.38 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,288.25 Typical High $4,786.30 | Facility | None | $562.34 | $1,288.25 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $575.44 | Professional | None | $234.42 | $302.00 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $151.36 Median $190.55 Typical High $363.08 | Professional | 62 · Two surgeons | $151.36 | $190.55 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $1,621.81 Typical High $2,089.30 | Facility | None | $275.42 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,818.38 | Facility | None | $602.56 | $1,819.70 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $691.83 | Professional | None | $223.87 | $380.19 | $691.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,884.03 | Facility | None | $602.56 | $1,862.09 | $2,884.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $691.83 | Professional | None | $223.87 | $380.19 | $691.83 |
Molina Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $660.69 | Professional | None | $371.54 | $478.63 | $660.69 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $199.53 Median $398.11 Typical High $512.86 | Professional | None | $199.53 | $398.11 | $512.86 |
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 $234.42 Median $380.19 Typical High $691.83 | Professional | None | $234.42 | $380.19 | $691.83 |
5 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 $107.15 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $107.15 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $42.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $162.18 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $32.36 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.38 | $40.74 | $40.74 |
Where Ohio sits
The same service costs 5.9 times more in Oklahoma than in West Virginia. 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.
Physician feeFacility fee
OK $4,893WV $835
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.