How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $5,248Professionalmedian $550 · 10th to 90th $98 to $912
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 $870.96 Median $4,365.16 Typical High $12,589.25 | Facility | None | $870.96 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $2,691.53 | Professional | None | $549.54 | $660.69 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $758.58 | Professional | None | $380.19 | $467.74 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $691.83 Typical High $831.76 | Facility | None | $630.96 | $691.83 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $707.95 Typical High $1,995.26 | Facility | None | $489.78 | $707.95 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,096.48 | Professional | None | $562.34 | $707.95 | $1,096.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $1,995.26 | Facility | None | $512.86 | $707.95 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,096.48 | Professional | None | $562.34 | $707.95 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $457.09 Typical High $851.14 | Professional | None | $67.61 | $457.09 | $851.14 |
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 $549.54 Median $691.83 Typical High $831.76 | Professional | None | $549.54 | $691.83 | $831.76 |
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 $363.08 Median $588.84 Typical High $1,071.52 | Professional | None | $363.08 | $588.84 | $1,071.52 |
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 $275.42 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $275.42 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $109.65 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $416.87 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $512.86 |
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· 47th of 51
$550
AK $2,399TX $427
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.