How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $9,120Professionalmedian $490 · 10th to 90th $79 to $813
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 $2,089.30 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,089.30 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $5,754.40 | Professional | None | $549.54 | $549.54 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,096.48 | Professional | None | $575.44 | $724.44 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $1,995.26 | Facility | None | $691.83 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,047.13 | Professional | None | $562.34 | $707.95 | $1,047.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,047.13 | Professional | None | $562.34 | $707.95 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $371.54 Typical High $645.65 | Professional | None | $70.79 | $371.54 | $645.65 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $707.95 | Professional | None | $489.78 | $537.03 | $707.95 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $1,071.52 | Professional | None | $346.74 | $645.65 | $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 $275.42 Typical High $1,047.13 | Professional | 52 · Reduced service | $275.42 | $275.42 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $416.87 | Professional | 53 · Discontinued | $109.65 | $109.65 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $1,548.82 | Professional | 54 · Surgery only | $407.38 | $407.38 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $309.03 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $208.93 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $1,445.44 |
Where Ohio sits
The same service costs 4.1 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $7,594MT $1,845
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.