How much rates vary
Facilitymedian $631 · 10th to 90th $195 to $3,715Professionalmedian $229 · 10th to 90th $117 to $407
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 $302.00 Median $912.01 Typical High $10,715.19 | Facility | None | $302.00 | $912.01 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $794.33 | Professional | None | $165.96 | $251.19 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $316.23 Typical High $316.23 | Professional | None | $112.20 | $316.23 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $3,388.44 | Facility | None | $389.05 | $851.14 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $331.13 | Professional | None | $134.90 | $204.17 | $331.13 |
Aultcare Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $213.80 Typical High $234.42 | Facility | None | $162.18 | $213.80 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $346.74 | Professional | None | $281.84 | $281.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $1,479.11 | Facility | None | $169.82 | $302.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $436.52 | Professional | None | $158.49 | $234.42 | $436.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $169.82 Median $316.23 Typical High $1,479.11 | Facility | None | $169.82 | $316.23 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $426.58 | Professional | None | $117.49 | $229.09 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $234.42 Typical High $363.08 | Professional | None | $33.88 | $234.42 | $363.08 |
SummaCare Setting Facility Modifier None Typical Low $89.13 Median $93.33 Typical High $107.15 | Facility | None | $89.13 | $93.33 | $107.15 |
SummaCare Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $426.58 | Professional | None | $165.96 | $263.03 | $426.58 |
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 $151.36 Median $239.88 Typical High $446.68 | Professional | None | $151.36 | $239.88 | $446.68 |
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 $83.18 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $83.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $33.11 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $25.12 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.60 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $117.49 | $165.96 | $165.96 |
Where Ohio sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$234
AK $776TX $214
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.