How much rates vary
Facilitymedian $646 · 10th to 90th $178 to $4,786Professionalmedian $191 · 10th to 90th $132 to $316
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 $263.03 Median $691.83 Typical High $10,715.19 | Facility | None | $263.03 | $691.83 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $436.52 | Professional | None | $114.82 | $186.21 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $309.03 | Professional | None | $109.65 | $165.96 | $309.03 |
Aultcare Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $181.97 | Facility | None | $138.04 | $177.83 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $275.42 Typical High $1,479.11 | Facility | None | $154.88 | $275.42 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $316.23 | Professional | None | $147.91 | $204.17 | $316.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $154.88 Median $275.42 Typical High $1,479.11 | Facility | None | $154.88 | $275.42 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $316.23 | Professional | None | $147.91 | $204.17 | $316.23 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $316.23 | Professional | None | $147.91 | $208.93 | $316.23 |
SummaCare Setting Facility Modifier None Typical Low $83.18 Median $87.10 Typical High $97.72 | Facility | None | $83.18 | $87.10 | $97.72 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $263.03 | Professional | None | $141.25 | $186.21 | $263.03 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $316.23 | Professional | None | $107.15 | $173.78 | $316.23 |
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 $70.79 Median $102.33 Typical High $107.15 | Professional | 52 · Reduced service | $70.79 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $28.18 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $158.49 | Professional | 54 · Surgery only | $107.15 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $147.91 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 46th of 51
$195
AK $603FL $174
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.