How much rates vary
Facilitymedian $537 · 10th to 90th $148 to $3,715Professionalmedian $162 · 10th to 90th $112 to $302
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 $194.98 Median $512.86 Typical High $10,232.93 | Facility | None | $194.98 | $512.86 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $549.54 | Professional | None | $128.82 | $181.97 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $144.54 | Professional | None | $72.44 | $112.20 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $3,388.44 | Facility | None | $363.08 | $851.14 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $245.47 | Professional | None | $102.33 | $151.36 | $245.47 |
Aultcare Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | None | $223.87 | $223.87 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $181.97 | Facility | None | $120.23 | $154.88 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | None | $199.53 | $199.53 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $229.09 Typical High $1,479.11 | Facility | None | $128.82 | $229.09 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $302.00 | Professional | None | $123.03 | $165.96 | $302.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $128.82 Median $281.84 Typical High $1,479.11 | Facility | None | $128.82 | $281.84 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $275.42 | Professional | None | $87.10 | $144.54 | $275.42 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $281.84 | Professional | None | $125.89 | $190.55 | $281.84 |
SummaCare Setting Facility Modifier None Typical Low $67.61 Median $70.79 Typical High $81.28 | Facility | None | $67.61 | $70.79 | $81.28 |
SummaCare Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $309.03 | Professional | None | $134.90 | $199.53 | $309.03 |
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 $120.23 Median $173.78 Typical High $316.23 | Professional | None | $120.23 | $173.78 | $316.23 |
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 $64.57 Median $85.11 Typical High $89.13 | Professional | 52 · Reduced service | $64.57 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.88 Typical High $35.48 | Professional | 53 · Discontinued | $25.70 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $125.89 Typical High $134.90 | Professional | 54 · Surgery only | $97.72 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.12 Typical High $26.92 | Professional | 55 · Aftercare only | $19.50 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.98 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.88 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $117.49 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $91.20 | $117.49 | $125.89 |
Where Ohio sits
The same service costs 4.0 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· 49th of 51
$170
AK $617KY $155
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.