How much rates vary
Facilitymedian $676 · 10th to 90th $158 to $5,754Professionalmedian $363 · 10th to 90th $204 to $617
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 $407.38 Median $1,202.26 Typical High $10,964.78 | Facility | None | $407.38 | $1,202.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $1,202.26 | Professional | None | $223.87 | $363.08 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $549.54 | Professional | None | $302.00 | $316.23 | $549.54 |
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 $229.09 Median $338.84 Typical High $524.81 | Professional | None | $229.09 | $338.84 | $524.81 |
Aultcare Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $794.33 | Professional | None | $467.74 | $467.74 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $416.87 | Facility | None | $316.23 | $316.23 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | None | $426.58 | $426.58 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $389.05 Typical High $2,398.83 | Facility | None | $213.80 | $389.05 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $676.08 | Professional | None | $251.19 | $416.87 | $676.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $213.80 Median $398.11 Typical High $2,398.83 | Facility | None | $213.80 | $398.11 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $602.56 | Professional | None | $245.47 | $281.84 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $371.54 Typical High $562.34 | Professional | None | $33.88 | $371.54 | $562.34 |
SummaCare Setting Facility Modifier None Typical Low $114.82 Median $120.23 Typical High $138.04 | Facility | None | $114.82 | $120.23 | $138.04 |
SummaCare Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $616.60 | Professional | None | $218.78 | $346.74 | $616.60 |
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 $229.09 Median $363.08 Typical High $660.69 | Professional | None | $229.09 | $363.08 | $660.69 |
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 $112.20 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $112.20 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $44.67 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $269.15 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $53.70 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.39 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $251.19 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $154.88 | $251.19 | $257.04 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$372
AK $1,047FL $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.