How much rates vary
Facilitymedian $550 · 10th to 90th $100 to $3,715Professionalmedian $275 · 10th to 90th $46 to $468
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 $1,023.29 Typical High $10,715.19 | Facility | None | $501.19 | $1,023.29 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $954.99 | Professional | None | $281.84 | $302.00 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $186.21 Median $234.42 Typical High $389.05 | Professional | None | $186.21 | $234.42 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $346.74 Typical High $575.44 | Professional | 50 · Both sides | $275.42 | $346.74 | $575.44 |
Aultcare Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $562.34 | Professional | None | $389.05 | $562.34 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $363.08 | Facility | None | $125.89 | $162.18 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $263.03 | Facility | None | $58.88 | $144.54 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $524.81 | Professional | None | $281.84 | $354.81 | $524.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $288.40 | Facility | None | $58.88 | $144.54 | $288.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $524.81 | Professional | None | $281.84 | $354.81 | $524.81 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $181.97 Typical High $426.58 | Professional | None | $32.36 | $181.97 | $426.58 |
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 $288.40 Median $338.84 Typical High $457.09 | Professional | None | $288.40 | $338.84 | $457.09 |
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 $190.55 Median $288.40 Typical High $512.86 | Professional | None | $190.55 | $288.40 | $512.86 |
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 $141.25 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $229.09 |
Where Ohio sits
The same service costs 5.8 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· 46th of 51
$282
AK $1,202TX $209
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.