How much rates vary
Facilitymedian $1,660 · 10th to 90th $490 to $8,128Professionalmedian $813 · 10th to 90th $93 to $1,230
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 $1,380.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $4,168.69 | Professional | None | $776.25 | $776.25 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,348.96 Typical High $4,677.35 | Facility | None | $467.74 | $1,348.96 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,318.26 | Professional | None | $691.83 | $812.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,230.27 Typical High $1,995.26 | Professional | 50 · Both sides | $1,047.13 | $1,230.27 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,737.80 | Facility | None | $1,000.00 | $1,348.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,479.11 Typical High $2,290.87 | Facility | None | $363.08 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,737.80 | Professional | None | $724.44 | $851.14 | $1,737.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,479.11 Typical High $2,238.72 | Facility | None | $389.05 | $1,479.11 | $2,238.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,737.80 | Professional | None | $724.44 | $851.14 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $741.31 Typical High $1,071.52 | Professional | None | $79.43 | $741.31 | $1,071.52 |
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 $758.58 Median $758.58 Typical High $1,202.26 | Professional | None | $758.58 | $758.58 | $1,202.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,862.09 | Professional | None | $724.44 | $933.25 | $1,862.09 |
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 $389.05 Median $389.05 Typical High $1,445.44 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $575.44 | Professional | 53 · Discontinued | $154.88 | $154.88 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $2,187.76 | Professional | 54 · Surgery only | $575.44 | $575.44 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $436.52 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $288.40 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $2,041.74 |
Where Ohio sits
The same service costs 6.9 times more in Oklahoma 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· 49th of 51
$813
OK $3,890UT $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.