How much rates vary
Facilitymedian $355 · 10th to 90th $95 to $3,548Professionalmedian $129 · 10th to 90th $83 to $234
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 $138.04 Median $436.52 Typical High $10,232.93 | Facility | None | $138.04 | $436.52 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $489.78 | Professional | None | $91.20 | $138.04 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $162.18 Typical High $234.42 | Professional | None | $67.61 | $162.18 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $3,311.31 | Facility | None | $363.08 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $186.21 | Professional | None | $79.43 | $112.20 | $186.21 |
Aultcare Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $128.82 Typical High $128.82 | Facility | None | $100.00 | $128.82 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $186.21 | Professional | None | $151.36 | $151.36 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $120.23 Typical High $208.93 | Facility | None | $58.88 | $120.23 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $239.88 | Professional | None | $100.00 | $144.54 | $239.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $123.03 Typical High $346.74 | Facility | None | $58.88 | $123.03 | $346.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $239.88 | Professional | None | $100.00 | $131.83 | $239.88 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $213.80 | Professional | None | $112.20 | $151.36 | $213.80 |
SummaCare Setting Facility Modifier None Typical Low $58.88 Median $61.66 Typical High $69.18 | Facility | None | $58.88 | $61.66 | $69.18 |
SummaCare Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $181.97 | Professional | None | $95.50 | $102.33 | $181.97 |
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 $83.18 Median $128.82 Typical High $239.88 | Professional | None | $83.18 | $128.82 | $239.88 |
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 $45.71 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $45.71 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $18.20 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $67.61 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $13.49 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.12 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $91.20 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $63.10 | $91.20 | $91.20 |
Where Ohio sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$132
AK $447KY $110
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.