How much rates vary
Facilitymedian $1,479 · 10th to 90th $617 to $7,762Professionalmedian $794 · 10th to 90th $100 to $1,259
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 $2,511.89 Median $5,754.40 Typical High $12,022.64 | Facility | None | $2,511.89 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $7,079.46 | Professional | None | $977.24 | $977.24 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $4,786.30 | Facility | None | $562.34 | $1,148.15 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,318.26 | Professional | None | $676.08 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,949.84 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,288.25 | Facility | None | $1,000.00 | $1,174.90 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,398.83 | Facility | None | $602.56 | $1,148.15 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,479.11 | Professional | None | $691.83 | $1,000.00 | $1,479.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,398.83 | Facility | None | $602.56 | $1,148.15 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,479.11 | Professional | None | $691.83 | $1,000.00 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $575.44 Typical High $1,023.29 | Professional | None | $69.18 | $575.44 | $1,023.29 |
SummaCare Setting Facility Modifier None Typical Low $562.34 Median $588.84 Typical High $660.69 | Facility | None | $562.34 | $588.84 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,230.27 | Professional | None | $851.14 | $851.14 | $1,230.27 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,737.80 | Professional | None | $776.25 | $954.99 | $1,737.80 |
7 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 $489.78 Median $489.78 Typical High $1,548.82 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $616.60 | Professional | 53 · Discontinued | $194.98 | $194.98 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $2,344.23 | Professional | 54 · Surgery only | $724.44 | $724.44 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $467.74 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $309.03 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $812.83 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $812.83 |
Where Ohio sits
The same service costs 7.4 times more in Alaska 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
$794
AK $3,981UT $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.