How much rates vary
Facilitymedian $501 · 10th to 90th $76 to $4,169Professionalmedian $59 · 10th to 90th $39 to $110
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 $83.18 Median $208.93 Typical High $10,715.19 | Facility | None | $83.18 | $208.93 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $173.78 | Professional | None | $46.77 | $67.61 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $97.72 | Professional | None | $45.71 | $69.18 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $89.13 | Professional | None | $38.90 | $57.54 | $89.13 |
Aultcare Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $91.20 | Professional | None | $74.13 | $74.13 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $537.03 Typical High $812.83 | Facility | None | $66.07 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | None | $69.18 | $69.18 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $125.89 | Professional | None | $43.65 | $54.95 | $125.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $524.81 | Facility | None | $50.12 | $75.86 | $524.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $120.23 | Professional | None | $40.74 | $56.23 | $120.23 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $93.33 | Professional | None | $30.90 | $54.95 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $93.33 | Professional | None | $47.86 | $58.88 | $93.33 |
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 $43.65 Median $61.66 Typical High $109.65 | Professional | None | $43.65 | $61.66 | $109.65 |
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 $23.44 Median $28.84 Typical High $31.62 | Professional | 52 · Reduced service | $23.44 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.48 Typical High $12.88 | Professional | 53 · Discontinued | $9.33 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $42.66 Typical High $47.86 | Professional | 54 · Surgery only | $35.48 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.71 Typical High $9.55 | Professional | 55 · Aftercare only | $7.08 | $8.71 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.75 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.68 | $5.75 | $6.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $39.81 Typical High $44.67 | Professional | 78 · Unplanned return to OR | $33.11 | $39.81 | $44.67 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $47.86 Median $63.10 Typical High $75.86 | Professional | 59 · Distinct service | $47.86 | $63.10 | $75.86 |
Where Ohio sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 47th of 51
$61.66
AK $224KY $53.70
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.