How much rates vary
Facilitymedian $1,230 · 10th to 90th $589 to $10,000Professionalmedian $631 · 10th to 90th $105 to $1,023
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 $1,348.96 Median $10,000.00 Typical High $13,803.84 | Facility | None | $1,348.96 | $10,000.00 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $2,570.40 | Professional | None | $616.60 | $776.25 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $4,786.30 | Facility | None | $645.65 | $1,348.96 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $912.01 | Professional | None | $478.63 | $602.56 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $831.76 | Facility | None | $630.96 | $794.33 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $977.24 Typical High $4,677.35 | Facility | None | $630.96 | $977.24 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,258.93 | Professional | None | $630.96 | $794.33 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $630.96 Median $977.24 Typical High $4,677.35 | Facility | None | $630.96 | $977.24 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,202.26 | Professional | None | $630.96 | $794.33 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $537.03 Typical High $954.99 | Professional | None | $70.79 | $537.03 | $954.99 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $933.25 | Professional | None | $575.44 | $758.58 | $933.25 |
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 $467.74 Median $707.95 Typical High $1,230.27 | Professional | None | $467.74 | $707.95 | $1,230.27 |
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 $309.03 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $123.03 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $61.66 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $575.44 |
Where Ohio sits
The same service costs 5.6 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
$631
AK $2,630TX $468
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.