How much rates vary
Facilitymedian $871 · 10th to 90th $389 to $4,467Professionalmedian $240 · 10th to 90th $60 to $427
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 $537.03 Median $1,995.26 Typical High $10,964.78 | Facility | None | $537.03 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $933.25 | Professional | None | $194.98 | $245.47 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $275.42 | Professional | None | $87.10 | $87.10 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $4,466.84 | Facility | None | $467.74 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $371.54 | Professional | None | $169.82 | $239.88 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $691.83 Typical High $891.25 | Facility | None | $275.42 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $1,479.11 | Facility | None | $363.08 | $794.33 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $467.74 | Professional | None | $186.21 | $239.88 | $467.74 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $467.74 | Professional | None | $190.55 | $239.88 | $467.74 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $213.80 Typical High $354.81 | Professional | None | $32.36 | $213.80 | $354.81 |
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 $204.17 Median $288.40 Typical High $416.87 | Professional | None | $204.17 | $288.40 | $416.87 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $467.74 | Professional | None | $186.21 | $263.03 | $467.74 |
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 $97.72 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $97.72 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $38.90 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $147.91 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $138.04 | $169.82 | $190.55 |
Where Ohio sits
The same service costs 3.9 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
$257
AK $912KY $234
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.