How much rates vary
Facilitymedian $617 · 10th to 90th $126 to $4,365Professionalmedian $417 · 10th to 90th $79 to $676
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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $3,548.13 | Professional | None | $524.81 | $524.81 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $3,715.35 | Facility | None | $407.38 | $831.76 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $707.95 | Professional | None | $331.13 | $416.87 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $630.96 Typical High $1,071.52 | Professional | 50 · Both sides | $501.19 | $630.96 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $660.69 | Facility | None | $125.89 | $162.18 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $1,995.26 | Facility | None | $131.83 | $245.47 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $891.25 | Professional | None | $524.81 | $660.69 | $891.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $1,995.26 | Facility | None | $131.83 | $234.42 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $891.25 | Professional | None | $524.81 | $660.69 | $891.25 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $354.81 Typical High $602.56 | Professional | None | $70.79 | $354.81 | $602.56 |
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 $467.74 Median $524.81 Typical High $676.08 | Professional | None | $467.74 | $524.81 | $676.08 |
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 $323.59 Median $501.19 Typical High $954.99 | Professional | None | $323.59 | $501.19 | $954.99 |
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 $263.03 Median $263.03 Typical High $1,096.48 | Professional | 52 · Reduced service | $263.03 | $263.03 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $436.52 | Professional | 53 · Discontinued | $104.71 | $104.71 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,659.59 | Professional | 54 · Surgery only | $389.05 | $389.05 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $331.13 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $218.78 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,548.82 |
Where Ohio sits
The same service costs 7.9 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
$417
AK $2,188TX $275
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.