How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $7,244Professionalmedian $676 · 10th to 90th $102 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 $2,454.71 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,454.71 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $5,754.40 | Professional | None | $870.96 | $870.96 | $5,754.40 |
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 $512.86 Median $660.69 Typical High $1,096.48 | Professional | None | $512.86 | $660.69 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,174.90 Typical High $2,398.83 | Facility | None | $549.54 | $1,174.90 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,445.44 | Professional | None | $870.96 | $1,096.48 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,174.90 Typical High $2,398.83 | Facility | None | $549.54 | $1,174.90 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,445.44 | Professional | None | $870.96 | $1,096.48 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $645.65 Typical High $1,122.02 | Professional | None | $70.79 | $645.65 | $1,122.02 |
SummaCare Setting Facility Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,348.96 | Facility | None | $1,148.15 | $1,202.26 | $1,348.96 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,230.27 | Professional | None | $851.14 | $954.99 | $1,230.27 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,584.89 | Professional | None | $537.03 | $831.76 | $1,584.89 |
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 $436.52 Median $436.52 Typical High $1,412.54 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $575.44 | Professional | 53 · Discontinued | $173.78 | $173.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $2,137.96 | Professional | 54 · Surgery only | $660.69 | $660.69 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $426.58 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $288.40 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $1,995.26 |
Where Ohio sits
The same service costs 7.6 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
$692
AK $3,715TX $490
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.