How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,096 to $20,893Professionalmedian $1,096 · 10th to 90th $112 to $1,738
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 $2,089.30 Median $8,317.64 Typical High $13,803.84 | Facility | None | $2,089.30 | $8,317.64 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $3,019.95 Typical High $11,220.18 | Professional | None | $1,148.15 | $3,019.95 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,890.45 Typical High $20,892.96 | Facility | None | $1,047.13 | $3,890.45 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,698.24 | Professional | None | $954.99 | $1,122.02 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $22,387.21 Typical High $23,988.33 | Facility | None | $11,748.98 | $22,387.21 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,445.44 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $12,882.50 Median $22,387.21 Typical High $53,703.18 | Facility | None | $12,882.50 | $22,387.21 | $53,703.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,445.44 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $933.25 Typical High $1,258.93 | Professional | None | $97.72 | $933.25 | $1,258.93 |
SummaCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,096.48 | $1,905.46 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,380.38 | $2,818.38 |
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 $575.44 Median $575.44 Typical High $2,691.53 | Professional | 52 · Reduced service | $575.44 | $575.44 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $1,096.48 | Professional | 53 · Discontinued | $229.09 | $229.09 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $4,073.80 | Professional | 54 · Surgery only | $870.96 | $870.96 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $812.83 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $549.54 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $3,801.89 |
Where Ohio sits
The same service costs 8.9 times more in Oklahoma 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· 50th of 51
$1,122
OK $7,762TX $871
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.