How much rates vary
Facilitymedian $513 · 10th to 90th $132 to $3,715Professionalmedian $141 · 10th to 90th $89 to $263
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 $151.36 Median $446.68 Typical High $10,232.93 | Facility | None | $151.36 | $446.68 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $446.68 | Professional | None | $100.00 | $151.36 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $194.98 | Professional | None | $67.61 | $72.44 | $194.98 |
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 $81.28 Median $138.04 Typical High $208.93 | Professional | None | $81.28 | $138.04 | $208.93 |
Aultcare Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $323.59 | Professional | None | $190.55 | $190.55 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $144.54 | Facility | None | $109.65 | $141.25 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | None | $173.78 | $173.78 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $204.17 Typical High $1,479.11 | Facility | None | $114.82 | $204.17 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $263.03 | Professional | None | $93.33 | $141.25 | $263.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $114.82 Median $275.42 Typical High $1,479.11 | Facility | None | $114.82 | $275.42 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $218.78 | Professional | None | $74.13 | $107.15 | $218.78 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $239.88 | Professional | None | $123.03 | $165.96 | $239.88 |
SummaCare Setting Facility Modifier None Typical Low $61.66 Median $64.57 Typical High $72.44 | Facility | None | $61.66 | $64.57 | $72.44 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $239.88 | Professional | None | $102.33 | $138.04 | $239.88 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $263.03 | Professional | None | $95.50 | $144.54 | $263.03 |
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 $50.12 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $50.12 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $19.95 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $74.13 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.45 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.00 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $102.33 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $69.18 | $102.33 | $102.33 |
Where Ohio sits
The same service costs 3.8 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· 46th of 51
$151
AK $525KY $138
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.