How much rates vary
Facilitymedian $1,660 · 10th to 90th $646 to $8,511Professionalmedian $776 · 10th to 90th $105 to $1,175
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $9,120.11 | Professional | None | $812.83 | $812.83 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,698.24 Typical High $7,585.78 | Facility | None | $616.60 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,174.90 | Professional | None | $660.69 | $812.83 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,513.56 | Facility | None | $1,148.15 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,318.26 Typical High $2,398.83 | Facility | None | $562.34 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,548.82 | Professional | None | $776.25 | $891.25 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,548.82 | Professional | None | $776.25 | $891.25 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $602.56 Typical High $1,023.29 | Professional | None | $75.86 | $602.56 | $1,023.29 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,737.80 | Professional | None | $676.08 | $933.25 | $1,737.80 |
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 $407.38 Median $407.38 Typical High $2,089.30 | Professional | 52 · Reduced service | $407.38 | $407.38 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $831.76 | Professional | 53 · Discontinued | $162.18 | $162.18 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $3,162.28 | Professional | 54 · Surgery only | $602.56 | $602.56 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $630.96 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $416.87 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $2,951.21 |
Where Ohio sits
The same service costs 7.1 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· 49th of 51
$776
AK $3,802TX $537
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.