How much rates vary
Facilitymedian $513 · 10th to 90th $126 to $3,548Professionalmedian $186 · 10th to 90th $145 to $331
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 $229.09 Median $616.60 Typical High $10,715.19 | Facility | None | $229.09 | $616.60 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $676.08 | Professional | None | $158.49 | $213.80 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $338.84 | Professional | None | $165.96 | $199.53 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $275.42 | Professional | None | $125.89 | $169.82 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $223.87 | Facility | None | $114.82 | $151.36 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | None | $218.78 | $218.78 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $208.93 Typical High $1,479.11 | Facility | None | $123.03 | $208.93 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $338.84 | Professional | None | $177.83 | $213.80 | $338.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $125.89 Median $234.42 Typical High $1,479.11 | Facility | None | $125.89 | $234.42 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $316.23 | Professional | None | $165.96 | $204.17 | $316.23 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $288.40 | Professional | None | $154.88 | $204.17 | $288.40 |
SummaCare Setting Facility Modifier None Typical Low $67.61 Median $70.79 Typical High $79.43 | Facility | None | $67.61 | $70.79 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $288.40 | Professional | None | $158.49 | $173.78 | $288.40 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $354.81 | Professional | None | $138.04 | $190.55 | $354.81 |
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 $79.43 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $79.43 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $31.62 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.85 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $128.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $112.20 | $128.82 | $144.54 |
Where Ohio sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 45th of 51
$195
AK $759FL $174
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.