How much rates vary
Facilitymedian $851 · 10th to 90th $200 to $5,012Professionalmedian $200 · 10th to 90th $39 to $331
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 $501.19 Median $3,235.94 Typical High $12,589.25 | Facility | None | $501.19 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $537.03 | Professional | None | $158.49 | $245.47 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $251.19 | Professional | None | $117.49 | $147.91 | $251.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $218.78 Typical High $380.19 | Professional | 50 · Both sides | $177.83 | $218.78 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $218.78 | Facility | None | $165.96 | $199.53 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $316.23 Typical High $1,479.11 | Facility | None | $177.83 | $316.23 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $398.11 | Professional | None | $162.18 | $251.19 | $398.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $177.83 Median $316.23 Typical High $1,479.11 | Facility | None | $177.83 | $316.23 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $398.11 | Professional | None | $162.18 | $251.19 | $398.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $190.55 Typical High $316.23 | Professional | None | $30.20 | $190.55 | $316.23 |
SummaCare Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $112.20 | Facility | None | $95.50 | $100.00 | $112.20 |
SummaCare Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $302.00 | Professional | None | $151.36 | $208.93 | $302.00 |
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 $120.23 Median $194.98 Typical High $371.54 | Professional | None | $120.23 | $194.98 | $371.54 |
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 $79.43 Median $123.03 Typical High $128.82 | Professional | 52 · Reduced service | $79.43 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $48.98 Typical High $52.48 | Professional | 53 · Discontinued | $31.62 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $181.97 Typical High $194.98 | Professional | 54 · Surgery only | $117.49 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $23.44 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $24.55 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.85 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $169.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $109.65 | $169.82 | $181.97 |
Where Ohio sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 46th of 51
$204
AK $692UT $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.