How much rates vary
Facilitymedian $1,349 · 10th to 90th $575 to $6,026Professionalmedian $1,413 · 10th to 90th $209 to $2,291
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 $1,584.89 Median $4,365.16 Typical High $6,165.95 | Facility | None | $1,584.89 | $4,365.16 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $5,011.87 | Professional | None | $1,288.25 | $1,584.89 | $5,011.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $4,677.35 | Facility | None | $524.81 | $1,288.25 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,621.81 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,659.59 | Facility | None | $724.44 | $954.99 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $2,398.83 | Facility | None | $549.54 | $891.25 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,778.28 | $2,884.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $2,398.83 | Facility | None | $549.54 | $891.25 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,778.28 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $1,148.15 Typical High $2,041.74 | Professional | None | $141.25 | $1,148.15 | $2,041.74 |
SummaCare Setting Facility Modifier None Typical Low $426.58 Median $446.68 Typical High $501.19 | Facility | None | $426.58 | $446.68 | $501.19 |
SummaCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,548.82 | $2,041.74 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,737.80 | $2,884.03 |
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 $630.96 Median $794.33 Typical High $870.96 | Professional | 52 · Reduced service | $630.96 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $346.74 | Professional | 53 · Discontinued | $257.04 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $190.55 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $173.78 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $891.25 | $1,122.02 | $1,202.26 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 58 · Staged procedure | $2,398.83 | $2,398.83 | $2,398.83 |
Where Ohio sits
The same service costs 5.1 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
$1,413
AK $5,248TX $1,023
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.