How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,000 to $10,965Professionalmedian $1,202 · 10th to 90th $100 to $1,862
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 $3,715.35 Median $10,000.00 Typical High $13,803.84 | Facility | None | $3,715.35 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $10,232.93 | Professional | None | $1,174.90 | $1,174.90 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $7,943.28 | Facility | None | $933.25 | $2,238.72 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,230.27 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,862.09 Typical High $3,235.94 | Professional | 50 · Both sides | $1,548.82 | $1,862.09 | $3,235.94 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,548.82 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $3,162.28 Typical High $5,248.07 | Facility | None | $1,071.52 | $3,162.28 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,288.25 | $2,570.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,096.48 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,096.48 | $3,235.94 | $5,248.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,258.93 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $1,047.13 Typical High $1,621.81 | Professional | None | $83.18 | $1,047.13 | $1,621.81 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,174.90 | $1,778.28 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,380.38 | $2,884.03 |
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 $588.84 Median $588.84 Typical High $2,089.30 | Professional | 52 · Reduced service | $588.84 | $588.84 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $831.76 | Professional | 53 · Discontinued | $234.42 | $234.42 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $3,090.30 | Professional | 54 · Surgery only | $870.96 | $870.96 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $630.96 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $416.87 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $2,951.21 |
Where Ohio sits
The same service costs 6.2 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
$1,230
AK $5,248UT $851
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.