How much rates vary
Facilitymedian $2,570 · 10th to 90th $631 to $8,318Professionalmedian $692 · 10th to 90th $107 to $1,148
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 $1,778.28 Median $2,884.03 Typical High $10,964.78 | Facility | None | $1,778.28 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $2,344.23 | Professional | None | $630.96 | $758.58 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,348.96 | Professional | None | $630.96 | $776.25 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $2,818.38 Typical High $3,630.78 | Facility | None | $812.83 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,818.38 Typical High $4,570.88 | Facility | None | $489.78 | $2,818.38 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,348.96 | Professional | None | $691.83 | $870.96 | $1,348.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,884.03 Typical High $4,466.84 | Facility | None | $512.86 | $2,884.03 | $4,466.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,318.26 | Professional | None | $691.83 | $870.96 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $575.44 Typical High $1,000.00 | Professional | None | $70.79 | $575.44 | $1,000.00 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $977.24 | Professional | None | $616.60 | $794.33 | $977.24 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,380.38 | Professional | None | $501.19 | $831.76 | $1,380.38 |
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 $316.23 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $151.36 Typical High $169.82 | Professional | 53 · Discontinued | $128.82 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $478.63 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $446.68 | $524.81 | $588.84 |
Where Ohio sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 48th of 51
$724
AK $3,236UT $562
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.