How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,000 to $10,965Professionalmedian $851 · 10th to 90th $98 to $1,288
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 $2,344.23 Median $8,317.64 Typical High $13,182.57 | Facility | None | $2,344.23 | $8,317.64 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $10,964.78 | Professional | None | $851.14 | $851.14 | $10,964.78 |
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 $741.31 Median $870.96 Typical High $1,584.89 | Professional | None | $741.31 | $870.96 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,318.26 Typical High $2,344.23 | Professional | 50 · Both sides | $1,096.48 | $1,318.26 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,096.48 | $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 $776.25 Median $933.25 Typical High $1,862.09 | Professional | None | $776.25 | $933.25 | $1,862.09 |
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 $776.25 Median $912.01 Typical High $1,862.09 | Professional | None | $776.25 | $912.01 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $691.83 Typical High $1,122.02 | Professional | None | $83.18 | $691.83 | $1,122.02 |
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 $831.76 Median $831.76 Typical High $1,258.93 | Professional | None | $831.76 | $831.76 | $1,258.93 |
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 $776.25 Median $1,000.00 Typical High $2,041.74 | Professional | None | $776.25 | $1,000.00 | $2,041.74 |
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 $426.58 Median $426.58 Typical High $1,548.82 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $616.60 | Professional | 53 · Discontinued | $169.82 | $169.82 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,290.87 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $467.74 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $309.03 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $2,137.96 |
Where Ohio sits
The same service costs 7.2 times more in Alaska than in Texas. 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
$871
AK $3,715TX $513
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.