How much rates vary
Facilitymedian $2,455 · 10th to 90th $813 to $9,333Professionalmedian $1,479 · 10th to 90th $209 to $2,399
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 $9,332.54 Typical High $12,589.25 | Facility | None | $2,454.71 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $9,332.54 | Professional | None | $1,479.11 | $1,479.11 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,445.44 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $912.01 Typical High $1,584.89 | Professional | 62 · Two surgeons | $724.44 | $912.01 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $3,890.45 | Facility | None | $2,041.74 | $3,019.95 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,344.23 Typical High $6,025.60 | Facility | None | $707.95 | $2,344.23 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,548.82 | $2,137.96 | $3,388.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $6,025.60 | Facility | None | $1,047.13 | $2,344.23 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,548.82 | $2,137.96 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,380.38 Typical High $2,187.76 | Professional | None | $199.53 | $1,380.38 | $2,187.76 |
SummaCare Setting Facility Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,348.96 | Facility | None | $1,122.02 | $1,174.90 | $1,348.96 |
SummaCare Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,621.81 | $2,454.71 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,981.07 | Professional | None | $1,479.11 | $1,995.26 | $3,981.07 |
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 $741.31 Median $741.31 Typical High $3,715.35 | Professional | 52 · Reduced service | $741.31 | $741.31 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $1,513.56 | Professional | 53 · Discontinued | $295.12 | $295.12 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $5,623.41 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $1,122.02 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $741.31 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $5,248.07 |
Where Ohio sits
The same service costs 6.6 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
$1,514
AK $6,607TX $1,000
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.