How much rates vary
Facilitymedian $1,778 · 10th to 90th $631 to $8,710Professionalmedian $692 · 10th to 90th $89 to $1,096
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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $6,606.93 | Professional | None | $831.76 | $831.76 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,513.56 Typical High $7,585.78 | Facility | None | $616.60 | $1,513.56 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,174.90 | Professional | None | $588.84 | $741.31 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,071.52 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $3,019.95 | Facility | None | $741.31 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | None | $870.96 | $1,071.52 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,951.21 | Facility | None | $741.31 | $1,737.80 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | None | $870.96 | $1,071.52 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $588.84 Typical High $977.24 | Professional | None | $70.79 | $588.84 | $977.24 |
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 $741.31 Median $831.76 Typical High $1,071.52 | Professional | None | $741.31 | $831.76 | $1,071.52 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $1,548.82 | Professional | None | $537.03 | $891.25 | $1,548.82 |
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 $416.87 Median $416.87 Typical High $1,380.38 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $549.54 | Professional | 53 · Discontinued | $165.96 | $165.96 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,041.74 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $407.38 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $275.42 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $1,905.46 |
Where Ohio sits
The same service costs 7.1 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· 47th of 51
$708
AK $3,548TX $501
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.