How much rates vary
Facilitymedian $490 · 10th to 90th $83 to $4,074Professionalmedian $95 · 10th to 90th $54 to $182
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 $100.00 Median $323.59 Typical High $10,715.19 | Facility | None | $100.00 | $323.59 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $288.40 | Professional | None | $58.88 | $97.72 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $134.90 | Professional | None | $79.43 | $100.00 | $134.90 |
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 $45.71 Median $75.86 Typical High $128.82 | Professional | None | $45.71 | $75.86 | $128.82 |
Aultcare Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $134.90 | Professional | None | $77.62 | $123.03 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $537.03 Typical High $812.83 | Facility | None | $83.18 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | None | $112.20 | $112.20 | $138.04 |
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 $54.95 Median $91.20 Typical High $169.82 | Professional | None | $54.95 | $91.20 | $169.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $616.60 | Facility | None | $50.12 | $81.28 | $616.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $186.21 | Professional | None | $57.54 | $93.33 | $186.21 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $190.55 | Professional | None | $93.33 | $128.82 | $190.55 |
SummaCare Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $141.25 | Professional | None | $61.66 | $85.11 | $141.25 |
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 $53.70 Median $91.20 Typical High $173.78 | Professional | None | $53.70 | $91.20 | $173.78 |
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 $29.51 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $29.51 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $11.75 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $72.44 Typical High $72.44 | Professional | 54 · Surgery only | $43.65 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $8.71 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.89 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $67.61 Typical High $67.61 | Professional | 78 · Unplanned return to OR | $40.74 | $67.61 | $67.61 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $89.13 Median $112.20 Typical High $125.89 | Professional | 59 · Distinct service | $89.13 | $112.20 | $125.89 |
Where Ohio sits
The same service costs 3.9 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· 42nd of 51
$100
AK $309KY $79.43
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.