How much rates vary
Facilitymedian $437 · 10th to 90th $105 to $3,548Professionalmedian $209 · 10th to 90th $105 to $372
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 $223.87 Median $645.65 Typical High $10,232.93 | Facility | None | $223.87 | $645.65 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $724.44 | Professional | None | $128.82 | $223.87 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $309.03 | Professional | None | $190.55 | $245.47 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $281.84 | Professional | None | $109.65 | $162.18 | $281.84 |
Aultcare Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $489.78 | Professional | None | $288.40 | $288.40 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $181.97 Typical High $229.09 | Facility | None | $173.78 | $181.97 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | None | $263.03 | $263.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $199.53 Typical High $346.74 | Facility | None | $58.88 | $199.53 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $380.19 | Professional | None | $151.36 | $239.88 | $380.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $204.17 Typical High $524.81 | Facility | None | $58.88 | $204.17 | $524.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $380.19 | Professional | None | $151.36 | $234.42 | $380.19 |
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 $97.72 Median $102.33 Typical High $114.82 | Facility | None | $97.72 | $102.33 | $114.82 |
SummaCare Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $331.13 | Professional | None | $134.90 | $169.82 | $331.13 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $389.05 | Professional | None | $125.89 | $208.93 | $389.05 |
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 $64.57 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $64.57 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $26.30 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $97.72 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $19.50 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.88 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $154.88 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $91.20 | $154.88 | $154.88 |
Where Ohio sits
The same service costs 3.5 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· 42nd of 51
$219
AK $631KY $182
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.