How much rates vary
Facilitymedian $933 · 10th to 90th $398 to $4,677Professionalmedian $257 · 10th to 90th $49 to $479
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 $257.04 Median $1,202.26 Typical High $10,715.19 | Facility | None | $257.04 | $1,202.26 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $302.00 Typical High $645.65 | Professional | None | $128.82 | $302.00 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $4,466.84 | Facility | None | $467.74 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $223.87 | Professional | None | $117.49 | $147.91 | $223.87 |
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 $177.83 Median $691.83 Typical High $891.25 | Facility | None | $177.83 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $1,479.11 | Facility | None | $363.08 | $794.33 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $537.03 | Professional | None | $144.54 | $338.84 | $537.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $794.33 Typical High $1,479.11 | Facility | None | $389.05 | $794.33 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $489.78 | Professional | None | $144.54 | $251.19 | $489.78 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $302.00 Typical High $478.63 | Professional | None | $32.36 | $302.00 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $380.19 | Professional | None | $141.25 | $288.40 | $380.19 |
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 $109.65 Median $234.42 Typical High $575.44 | Professional | None | $109.65 | $234.42 | $575.44 |
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 $69.18 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $69.18 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $27.54 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $245.47 Typical High $275.42 | Professional | 54 · Surgery only | $104.71 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $20.89 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $13.80 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $229.09 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $97.72 | $229.09 | $257.04 |
Where Ohio sits
The same service costs 4.0 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
$269
AK $759KY $191
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.