How much rates vary
Facilitymedian $1,950 · 10th to 90th $603 to $8,318Professionalmedian $631 · 10th to 90th $95 to $1,072
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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $4,570.88 | Professional | None | $851.14 | $851.14 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $7,585.78 | Facility | None | $588.84 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,122.02 | Professional | None | $537.03 | $630.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $954.99 Typical High $1,659.59 | Professional | 50 · Both sides | $758.58 | $954.99 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $1,995.26 | Facility | None | $1,023.29 | $1,548.82 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,778.28 Typical High $2,630.27 | Facility | None | $489.78 | $1,778.28 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,258.93 | Professional | None | $616.60 | $831.76 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $2,570.40 | Facility | None | $512.86 | $1,819.70 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,258.93 | Professional | None | $616.60 | $831.76 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $512.86 Typical High $912.01 | Professional | None | $69.18 | $512.86 | $912.01 |
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 $758.58 Median $758.58 Typical High $1,000.00 | Professional | None | $758.58 | $758.58 | $1,000.00 |
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 $630.96 Median $776.25 Typical High $1,445.44 | Professional | None | $630.96 | $776.25 | $1,445.44 |
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 $426.58 Median $426.58 Typical High $1,288.25 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $512.86 | Professional | 53 · Discontinued | $169.82 | $169.82 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $1,905.46 | Professional | 54 · Surgery only | $645.65 | $645.65 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $380.19 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $257.04 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,778.28 |
Where Ohio sits
The same service costs 8.3 times more in Wyoming 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
$676
WY $4,074UT $490
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.