How much rates vary
Facilitymedian $501 · 10th to 90th $107 to $3,715Professionalmedian $245 · 10th to 90th $120 to $437
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 $309.03 Median $912.01 Typical High $10,232.93 | Facility | None | $309.03 | $912.01 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $933.25 | Professional | None | $173.78 | $269.15 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $309.03 | Professional | None | $117.49 | $177.83 | $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 $147.91 Median $213.80 Typical High $363.08 | Professional | None | $147.91 | $213.80 | $363.08 |
Aultcare Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | None | $346.74 | $346.74 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $245.47 Typical High $251.19 | Facility | None | $194.98 | $245.47 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $389.05 | Professional | None | $316.23 | $316.23 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $218.78 Typical High $380.19 | Facility | None | $58.88 | $218.78 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $457.09 | Professional | None | $199.53 | $295.12 | $457.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $223.87 Typical High $446.68 | Facility | None | $58.88 | $223.87 | $446.68 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $407.38 | Professional | None | $154.88 | $208.93 | $407.38 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $245.47 Typical High $398.11 | Professional | None | $32.36 | $245.47 | $398.11 |
SummaCare Setting Facility Modifier None Typical Low $107.15 Median $112.20 Typical High $128.82 | Facility | None | $107.15 | $112.20 | $128.82 |
SummaCare Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $398.11 | Professional | None | $173.78 | $229.09 | $398.11 |
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 $165.96 Median $257.04 Typical High $478.63 | Professional | None | $165.96 | $257.04 | $478.63 |
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 $85.11 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $34.67 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $128.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.38 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $186.21 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $120.23 | $186.21 | $186.21 |
Where Ohio sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$245
AK $813MD $219
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.