How much rates vary
Facilitymedian $479 · 10th to 90th $107 to $3,631Professionalmedian $229 · 10th to 90th $110 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 $263.03 Median $812.83 Typical High $10,232.93 | Facility | None | $263.03 | $812.83 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $812.83 | Professional | None | $144.54 | $245.47 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $371.54 | Professional | None | $144.54 | $144.54 | $371.54 |
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 $131.83 Median $194.98 Typical High $331.13 | Professional | None | $131.83 | $194.98 | $331.13 |
Aultcare Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $537.03 | Professional | None | $316.23 | $331.13 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $204.17 Typical High $234.42 | Facility | None | $181.97 | $204.17 | $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 $58.88 Median $208.93 Typical High $363.08 | Facility | None | $58.88 | $208.93 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $416.87 | Professional | None | $165.96 | $263.03 | $416.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $213.80 Typical High $467.74 | Facility | None | $58.88 | $213.80 | $467.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $416.87 | Professional | None | $151.36 | $245.47 | $416.87 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $239.88 Typical High $380.19 | Professional | None | $32.36 | $239.88 | $380.19 |
SummaCare Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $123.03 | Facility | None | $102.33 | $107.15 | $123.03 |
SummaCare Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $323.59 | Professional | None | $151.36 | $204.17 | $323.59 |
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 $141.25 Median $229.09 Typical High $426.58 | Professional | None | $141.25 | $229.09 | $426.58 |
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 $72.44 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $72.44 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $29.51 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $109.65 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $21.88 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.45 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $169.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $102.33 | $169.82 | $169.82 |
Where Ohio sits
The same service costs 3.4 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· 44th of 51
$229
AK $692KY $204
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.