How much rates vary
Facilitymedian $1,445 · 10th to 90th $575 to $7,079Professionalmedian $661 · 10th to 90th $155 to $1,096
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 $1,548.82 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,548.82 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $4,168.69 | Professional | None | $562.34 | $676.08 | $4,168.69 |
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 $512.86 Median $691.83 Typical High $1,047.13 | Professional | None | $512.86 | $691.83 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,230.27 | Facility | None | $794.33 | $954.99 | $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 $549.54 Median $676.08 Typical High $1,288.25 | Professional | None | $549.54 | $676.08 | $1,288.25 |
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 $549.54 Median $676.08 Typical High $1,288.25 | Professional | None | $549.54 | $676.08 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $588.84 Typical High $977.24 | Professional | None | $77.62 | $588.84 | $977.24 |
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 $575.44 Median $794.33 Typical High $933.25 | Professional | None | $575.44 | $794.33 | $933.25 |
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 $549.54 Median $741.31 Typical High $1,318.26 | Professional | None | $549.54 | $741.31 | $1,318.26 |
7 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 $281.84 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $281.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $112.20 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $416.87 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $389.05 | $467.74 | $537.03 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 51 · Multiple procedures | $239.88 | $239.88 | $239.88 |
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
$676
AK $2,630TX $589
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.