How much rates vary
Facilitymedian $851 · 10th to 90th $407 to $4,786Professionalmedian $269 · 10th to 90th $138 to $490
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 $316.23 Median $851.14 Typical High $10,232.93 | Facility | None | $316.23 | $851.14 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $933.25 | Professional | None | $213.80 | $302.00 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $338.84 | Professional | None | $151.36 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $4,466.84 | Facility | None | $524.81 | $1,122.02 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $398.11 | Professional | None | $181.97 | $245.47 | $398.11 |
Aultcare Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | None | $380.19 | $380.19 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $691.83 Typical High $891.25 | Facility | None | $309.03 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $1,995.26 | Facility | None | $512.86 | $794.33 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $501.19 | Professional | None | $204.17 | $269.15 | $501.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $524.81 Median $794.33 Typical High $1,995.26 | Facility | None | $524.81 | $794.33 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $524.81 | Professional | None | $213.80 | $269.15 | $524.81 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $309.03 Typical High $467.74 | Professional | None | $32.36 | $309.03 | $467.74 |
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 $229.09 Median $331.13 Typical High $389.05 | Professional | None | $229.09 | $331.13 | $389.05 |
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 $194.98 Median $288.40 Typical High $524.81 | Professional | None | $194.98 | $288.40 | $524.81 |
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 $107.15 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $107.15 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $60.26 | Professional | 53 · Discontinued | $43.65 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $223.87 | Professional | 54 · Surgery only | $162.18 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $45.71 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $21.38 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $190.55 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $151.36 | $190.55 | $208.93 |
Where Ohio sits
The same service costs 4.8 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
$288
AK $1,202KY $251
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.