How much rates vary
Facilitymedian $692 · 10th to 90th $204 to $5,754Professionalmedian $339 · 10th to 90th $195 to $562
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 $389.05 Median $1,122.02 Typical High $10,964.78 | Facility | None | $389.05 | $1,122.02 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $1,122.02 | Professional | None | $213.80 | $338.84 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $436.52 | Professional | None | $141.25 | $245.47 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $891.25 Typical High $3,715.35 | Facility | None | $407.38 | $891.25 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $478.63 | Professional | None | $208.93 | $302.00 | $478.63 |
Aultcare Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | None | $436.52 | $436.52 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $416.87 | Facility | None | $302.00 | $316.23 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | None | $398.11 | $398.11 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $2,398.83 | Facility | None | $389.05 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $630.96 | Professional | None | $245.47 | $389.05 | $630.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $380.19 Median $562.34 Typical High $2,398.83 | Facility | None | $380.19 | $562.34 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $724.44 | Professional | None | $245.47 | $380.19 | $724.44 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $338.84 Typical High $512.86 | Professional | None | $33.88 | $338.84 | $512.86 |
SummaCare Setting Facility Modifier None Typical Low $208.93 Median $218.78 Typical High $251.19 | Facility | None | $208.93 | $218.78 | $251.19 |
SummaCare Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $602.56 | Professional | None | $213.80 | $331.13 | $602.56 |
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 $213.80 Median $338.84 Typical High $630.96 | Professional | None | $213.80 | $338.84 | $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 $104.71 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $104.71 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $42.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $251.19 Typical High $257.04 | Professional | 54 · Surgery only | $158.49 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $50.12 Typical High $51.29 | Professional | 55 · Aftercare only | $31.62 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.38 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $234.42 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $147.91 | $234.42 | $239.88 |
Where Ohio sits
The same service costs 3.3 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· 44th of 51
$339
AK $1,000UT $302
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.