How much rates vary
Facilitymedian $490 · 10th to 90th $81 to $4,074Professionalmedian $155 · 10th to 90th $102 to $269
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 $354.81 Median $3,235.94 Typical High $12,589.25 | Facility | None | $354.81 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $575.44 | Professional | None | $102.33 | $154.88 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $100.00 Median $144.54 Typical High $229.09 | Professional | None | $100.00 | $144.54 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $144.54 | Facility | None | $102.33 | $134.90 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $199.53 | Facility | None | $58.88 | $117.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $269.15 | Professional | None | $97.72 | $147.91 | $269.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $199.53 | Facility | None | $58.88 | $117.49 | $199.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $269.15 | Professional | None | $100.00 | $154.88 | $269.15 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $239.88 | Professional | None | $123.03 | $169.82 | $239.88 |
SummaCare Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $67.61 | Facility | None | $56.23 | $58.88 | $67.61 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $204.17 | Professional | None | $102.33 | $154.88 | $204.17 |
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 $97.72 Median $151.36 Typical High $281.84 | Professional | None | $97.72 | $151.36 | $281.84 |
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 $51.29 Median $77.62 Typical High $79.43 | Professional | 52 · Reduced service | $51.29 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $30.90 Typical High $31.62 | Professional | 53 · Discontinued | $20.42 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $114.82 Typical High $120.23 | Professional | 54 · Surgery only | $75.86 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.91 Typical High $23.99 | Professional | 55 · Aftercare only | $15.14 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.23 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $107.15 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $70.79 | $107.15 | $112.20 |
Where Ohio sits
The same service costs 3.5 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· 45th of 51
$155
AK $479KY $138
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.