How much rates vary
Facilitymedian $1,660 · 10th to 90th $603 to $7,762Professionalmedian $617 · 10th to 90th $417 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 $954.99 Median $7,079.46 Typical High $12,589.25 | Facility | None | $954.99 | $7,079.46 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $5,754.40 | Professional | None | $436.52 | $588.84 | $5,754.40 |
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 $371.54 Median $501.19 Typical High $891.25 | Professional | None | $371.54 | $501.19 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $724.44 Typical High $1,288.25 | Professional | 50 · Both sides | $537.03 | $724.44 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $1,348.96 Typical High $1,737.80 | Facility | None | $575.44 | $1,348.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,584.89 Typical High $2,691.53 | Facility | None | $562.34 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,258.93 | Professional | None | $457.09 | $616.60 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $2,691.53 | Facility | None | $602.56 | $1,584.89 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,288.25 | Professional | None | $457.09 | $616.60 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,047.13 | Professional | None | $602.56 | $776.25 | $1,047.13 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $851.14 | Professional | None | $436.52 | $645.65 | $851.14 |
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 $436.52 Median $630.96 Typical High $1,174.90 | Professional | None | $436.52 | $630.96 | $1,174.90 |
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 $218.78 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $218.78 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $87.10 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $446.68 Typical High $467.74 | Professional | 54 · Surgery only | $323.59 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $89.13 Typical High $93.33 | Professional | 55 · Aftercare only | $66.07 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $43.65 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $416.87 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $302.00 | $416.87 | $436.52 |
Where Ohio sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 47th of 51
$646
AK $2,291KY $562
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.