How much rates vary
Facilitymedian $1,000 · 10th to 90th $490 to $5,012Professionalmedian $339 · 10th to 90th $182 to $589
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 $676.08 Median $2,691.53 Typical High $10,964.78 | Facility | None | $676.08 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $1,288.25 | Professional | None | $245.47 | $331.13 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $309.03 | Professional | None | $107.15 | $107.15 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $489.78 | Professional | None | $223.87 | $316.23 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $691.83 Typical High $891.25 | Facility | None | $346.74 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $1,995.26 | Facility | None | $489.78 | $794.33 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $645.65 | Professional | None | $234.42 | $331.13 | $645.65 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $645.65 | Professional | None | $234.42 | $331.13 | $645.65 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $363.08 Typical High $549.54 | Professional | None | $33.88 | $363.08 | $549.54 |
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 $245.47 Median $389.05 Typical High $588.84 | Professional | None | $245.47 | $389.05 | $588.84 |
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 $234.42 Median $354.81 Typical High $630.96 | Professional | None | $234.42 | $354.81 | $630.96 |
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 $123.03 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $48.98 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $181.97 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $36.31 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $24.55 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $169.82 | $234.42 | $245.47 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 45th of 51
$355
AK $1,259UT $324
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.