How much rates vary
Facilitymedian $1,445 · 10th to 90th $575 to $7,079Professionalmedian $851 · 10th to 90th $166 to $1,445
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 $1,862.09 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,862.09 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $2,884.03 | Professional | None | $707.95 | $870.96 | $2,884.03 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $4,786.30 | Facility | None | $562.34 | $1,148.15 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,412.54 | Professional | None | $724.44 | $977.24 | $1,412.54 |
Aultcare Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,230.27 | Facility | None | $954.99 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,202.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,621.81 | Professional | None | $676.08 | $831.76 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,202.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,548.82 | Professional | None | $707.95 | $870.96 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $724.44 Typical High $1,230.27 | Professional | None | $114.82 | $724.44 | $1,230.27 |
SummaCare Setting Facility Modifier None Typical Low $575.44 Median $616.60 Typical High $691.83 | Facility | None | $575.44 | $616.60 | $691.83 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,174.90 | Professional | None | $707.95 | $891.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,659.59 | Professional | None | $707.95 | $954.99 | $1,659.59 |
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 $354.81 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $354.81 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $141.25 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $524.81 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $676.08 |
Where Ohio sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 48th of 51
$871
AK $3,311TX $741
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.