How much rates vary
Facilitymedian $724 · 10th to 90th $372 to $4,266Professionalmedian $257 · 10th to 90th $138 to $447
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 $501.19 Median $2,344.23 Typical High $10,964.78 | Facility | None | $501.19 | $2,344.23 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $954.99 | Professional | None | $181.97 | $269.15 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $354.81 | Professional | None | $269.15 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $954.99 Typical High $3,715.35 | Facility | None | $426.58 | $954.99 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $371.54 | Professional | None | $158.49 | $229.09 | $371.54 |
Aultcare Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $588.84 | Professional | None | $346.74 | $346.74 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $478.63 | Facility | None | $257.04 | $363.08 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $524.81 Typical High $1,995.26 | Facility | None | $371.54 | $524.81 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $478.63 | Professional | None | $177.83 | $263.03 | $478.63 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $1,995.26 | Facility | None | $380.19 | $524.81 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $467.74 | Professional | None | $181.97 | $263.03 | $467.74 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $269.15 Typical High $407.38 | Professional | None | $33.88 | $269.15 | $407.38 |
SummaCare Setting Facility Modifier None Typical Low $199.53 Median $208.93 Typical High $239.88 | Facility | None | $199.53 | $208.93 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $407.38 | Professional | None | $186.21 | $309.03 | $407.38 |
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 $169.82 Median $269.15 Typical High $501.19 | Professional | None | $169.82 | $269.15 | $501.19 |
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 $91.20 Median $131.83 Typical High $138.04 | Professional | 52 · Reduced service | $91.20 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $52.48 Typical High $54.95 | Professional | 53 · Discontinued | $36.31 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $199.53 Typical High $204.17 | Professional | 54 · Surgery only | $138.04 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $39.81 Typical High $40.74 | Professional | 55 · Aftercare only | $27.54 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.30 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $186.21 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $128.82 | $186.21 | $190.55 |
Where Ohio sits
The same service costs 3.6 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
$263
AK $851KY $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.