How much rates vary
Facilitymedian $832 · 10th to 90th $355 to $4,677Professionalmedian $191 · 10th to 90th $132 to $347
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 $218.78 Median $645.65 Typical High $10,232.93 | Facility | None | $218.78 | $645.65 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $645.65 | Professional | None | $141.25 | $204.17 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $208.93 | Professional | None | $107.15 | $154.88 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,122.02 Typical High $4,466.84 | Facility | None | $467.74 | $1,122.02 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $275.42 | Professional | None | $112.20 | $173.78 | $275.42 |
Aultcare Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $691.83 Typical High $891.25 | Facility | None | $204.17 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $794.33 Typical High $1,479.11 | Facility | None | $389.05 | $794.33 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $346.74 | Professional | None | $134.90 | $186.21 | $346.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $794.33 Typical High $1,584.89 | Facility | None | $389.05 | $794.33 | $1,584.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $97.72 Median $181.97 Typical High $346.74 | Professional | None | $97.72 | $181.97 | $346.74 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $346.74 | Professional | None | $181.97 | $239.88 | $346.74 |
SummaCare Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $457.09 | Facility | None | $380.19 | $398.11 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $275.42 | Professional | None | $154.88 | $177.83 | $275.42 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $363.08 | Professional | None | $131.83 | $194.98 | $363.08 |
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 $70.79 Median $95.50 Typical High $100.00 | Professional | 52 · Reduced service | $70.79 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $28.18 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $144.54 Typical High $147.91 | Professional | 54 · Surgery only | $107.15 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $21.38 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.13 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $134.90 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $100.00 | $134.90 | $138.04 |
Where Ohio sits
The same service costs 4.6 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· 47th of 51
$209
AK $794KY $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.