How much rates vary
Facilitymedian $1,047 · 10th to 90th $537 to $7,244Professionalmedian $661 · 10th to 90th $93 to $977
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 $2,290.87 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,290.87 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $9,120.11 | Professional | None | $616.60 | $616.60 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,230.27 Typical High $4,786.30 | Facility | None | $562.34 | $1,230.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,122.02 | Professional | None | $575.44 | $676.08 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,000.00 Typical High $1,659.59 | Professional | 50 · Both sides | $851.14 | $1,000.00 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $831.76 | Facility | None | $630.96 | $812.83 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $741.31 Typical High $2,398.83 | Facility | None | $562.34 | $741.31 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,348.96 | Professional | None | $575.44 | $676.08 | $1,348.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $2,398.83 | Facility | None | $575.44 | $741.31 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,348.96 | Professional | None | $575.44 | $676.08 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $588.84 Typical High $851.14 | Professional | None | $79.43 | $588.84 | $851.14 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $954.99 | Professional | None | $602.56 | $602.56 | $954.99 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,479.11 | Professional | None | $602.56 | $758.58 | $1,479.11 |
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 $309.03 Median $309.03 Typical High $1,148.15 | Professional | 52 · Reduced service | $309.03 | $309.03 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $467.74 | Professional | 53 · Discontinued | $123.03 | $123.03 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $1,737.80 | Professional | 54 · Surgery only | $457.09 | $457.09 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $346.74 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $234.42 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $1,621.81 |
Where Ohio sits
The same service costs 5.9 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· 47th of 51
$676
AK $2,692UT $457
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.