How much rates vary
Facilitymedian $513 · 10th to 90th $117 to $4,169Professionalmedian $135 · 10th to 90th $93 to $245
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 $154.88 Median $416.87 Typical High $10,232.93 | Facility | None | $154.88 | $416.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $457.09 | Professional | None | $93.33 | $141.25 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $162.18 | Professional | None | $74.13 | $100.00 | $162.18 |
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 $89.13 Median $125.89 Typical High $199.53 | Professional | None | $89.13 | $125.89 | $199.53 |
Aultcare Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $128.82 Typical High $131.83 | Facility | None | $97.72 | $128.82 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $194.98 | Professional | None | $158.49 | $158.49 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $181.97 Typical High $1,479.11 | Facility | None | $102.33 | $181.97 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $251.19 | Professional | None | $91.20 | $134.90 | $251.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $102.33 Median $190.55 Typical High $1,479.11 | Facility | None | $102.33 | $190.55 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $229.09 | Professional | None | $93.33 | $114.82 | $229.09 |
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 $54.95 Median $57.54 Typical High $66.07 | Facility | None | $54.95 | $57.54 | $66.07 |
SummaCare Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $239.88 | Professional | None | $100.00 | $158.49 | $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 $91.20 Median $138.04 Typical High $251.19 | Professional | None | $91.20 | $138.04 | $251.19 |
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 $46.77 Median $67.61 Typical High $69.18 | Professional | 52 · Reduced service | $46.77 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $19.05 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $104.71 | Professional | 54 · Surgery only | $70.79 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $20.89 | Professional | 55 · Aftercare only | $14.13 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.33 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $95.50 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $66.07 | $95.50 | $97.72 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 48th of 51
$138
AK $447FL $126
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.