How much rates vary
Facilitymedian $1,660 · 10th to 90th $692 to $8,511Professionalmedian $537 · 10th to 90th $100 to $891
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 $912.01 Median $8,128.31 Typical High $13,803.84 | Facility | None | $912.01 | $8,128.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $2,570.40 | Professional | None | $512.86 | $602.56 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $4,897.79 | Facility | None | $645.65 | $1,348.96 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $1,071.52 | Professional | None | $426.58 | $537.03 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $1,737.80 | Facility | None | $660.69 | $1,348.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,951.21 | Facility | None | $741.31 | $1,584.89 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,122.02 | Professional | None | $549.54 | $691.83 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,951.21 | Facility | None | $741.31 | $1,584.89 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,096.48 | Professional | None | $549.54 | $691.83 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $426.58 Typical High $794.33 | Professional | None | $70.79 | $426.58 | $794.33 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $758.58 | Professional | None | $512.86 | $630.96 | $758.58 |
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 $380.19 Median $645.65 Typical High $1,096.48 | Professional | None | $380.19 | $645.65 | $1,096.48 |
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 $257.04 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $257.04 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $102.33 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $457.09 Typical High $512.86 | Professional | 54 · Surgery only | $389.05 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $77.62 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $60.26 Typical High $69.18 | Professional | 56 · Pre-op care only | $51.29 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $426.58 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $363.08 | $426.58 | $478.63 |
Where Ohio sits
The same service costs 6.5 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· 49th of 51
$550
AK $2,630TX $407
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.