How much rates vary
Facilitymedian $1,047 · 10th to 90th $295 to $5,754Professionalmedian $282 · 10th to 90th $51 to $490
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 $724.44 Median $1,995.26 Typical High $10,964.78 | Facility | None | $724.44 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $1,047.13 | Professional | None | $257.04 | $363.08 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,570.88 | Facility | None | $524.81 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $446.68 | Professional | None | $213.80 | $263.03 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $331.13 | Facility | None | $245.47 | $316.23 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $436.52 Typical High $2,398.83 | Facility | None | $257.04 | $436.52 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $588.84 | Professional | None | $275.42 | $380.19 | $588.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $2,398.83 | Facility | None | $257.04 | $407.38 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $588.84 | Professional | None | $275.42 | $380.19 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $251.19 Typical High $436.52 | Professional | None | $33.88 | $251.19 | $436.52 |
SummaCare Setting Facility Modifier None Typical Low $138.04 Median $144.54 Typical High $165.96 | Facility | None | $138.04 | $144.54 | $165.96 |
SummaCare Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $446.68 | Professional | None | $251.19 | $331.13 | $446.68 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $575.44 | Professional | None | $194.98 | $323.59 | $575.44 |
7 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 $128.82 Median $181.97 Typical High $194.98 | Professional | 52 · Reduced service | $128.82 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $52.48 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $194.98 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $38.90 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $181.97 | $251.19 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $398.11 Typical High $660.69 | Professional | 50 · Both sides | $316.23 | $398.11 | $660.69 |
Where Ohio sits
The same service costs 4.8 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· 47th of 51
$295
AK $1,122TX $234
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.