How much rates vary
Facilitymedian $603 · 10th to 90th $129 to $3,631Professionalmedian $240 · 10th to 90th $49 to $398
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 $467.74 Median $912.01 Typical High $10,715.19 | Facility | None | $467.74 | $912.01 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $870.96 | Professional | None | $257.04 | $269.15 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $363.08 | Professional | None | $169.82 | $213.80 | $363.08 |
Aultcare Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $331.13 | Facility | None | $125.89 | $162.18 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $1,479.11 | Facility | None | $131.83 | $245.47 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $467.74 | Professional | None | $257.04 | $316.23 | $467.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $1,479.11 | Facility | None | $131.83 | $234.42 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $457.09 | Professional | None | $257.04 | $316.23 | $457.09 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $194.98 Typical High $354.81 | Professional | None | $33.88 | $194.98 | $354.81 |
SummaCare Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $83.18 | Facility | None | $69.18 | $72.44 | $83.18 |
SummaCare Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $354.81 | Professional | None | $269.15 | $309.03 | $354.81 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $457.09 | Professional | None | $165.96 | $263.03 | $457.09 |
7 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 $128.82 Median $134.90 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $57.54 | Professional | 53 · Discontinued | $51.29 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $213.80 | Professional | 54 · Surgery only | $190.55 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $38.90 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $177.83 | $186.21 | $199.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $316.23 Typical High $537.03 | Professional | 50 · Both sides | $257.04 | $316.23 | $537.03 |
Where Ohio sits
The same service costs 5.9 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
$245
AK $1,096TX $186
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.