How much rates vary
Facilitymedian $1,585 · 10th to 90th $603 to $7,079Professionalmedian $1,862 · 10th to 90th $316 to $2,951
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 $1,698.24 Median $2,041.74 Typical High $7,943.28 | Facility | None | $1,698.24 | $2,041.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,698.24 | $2,041.74 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,137.96 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,235.94 Typical High $4,897.79 | Professional | 50 · Both sides | $2,570.40 | $3,235.94 | $4,897.79 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,122.02 | Facility | None | $870.96 | $870.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,047.13 Typical High $2,398.83 | Facility | None | $549.54 | $1,047.13 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,344.23 | $3,715.35 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,047.13 Typical High $2,398.83 | Facility | None | $549.54 | $1,047.13 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,344.23 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $1,513.56 Typical High $2,630.27 | Professional | None | $213.80 | $1,513.56 | $2,630.27 |
SummaCare Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $602.56 | Facility | None | $501.19 | $524.81 | $602.56 |
SummaCare Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,584.89 | $2,041.74 | $2,570.40 |
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 $1,380.38 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,380.38 | $2,290.87 | $3,715.35 |
5 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 $851.14 Median $1,023.29 Typical High $1,122.02 | Professional | 52 · Reduced service | $851.14 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $407.38 Typical High $457.09 | Professional | 53 · Discontinued | $338.84 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $309.03 Typical High $338.84 | Professional | 55 · Aftercare only | $251.19 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $204.17 Typical High $223.87 | Professional | 56 · Pre-op care only | $169.82 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,412.54 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,412.54 | $1,584.89 |
Where Ohio sits
The same service costs 5.5 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· 48th of 51
$1,862
AK $6,918TX $1,259
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.