How much rates vary
Facilitymedian $2,239 · 10th to 90th $603 to $7,762Professionalmedian $708 · 10th to 90th $89 to $1,349
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $5,754.40 | Professional | None | $1,047.13 | $1,047.13 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,548.82 Typical High $7,585.78 | Facility | None | $616.60 | $1,548.82 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $1,230.27 | Professional | None | $416.87 | $524.81 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,318.26 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,801.89 | Facility | None | $602.56 | $2,398.83 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,348.96 | $1,737.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,548.13 | Facility | None | $602.56 | $2,398.83 | $3,548.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,348.96 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $660.69 Typical High $1,174.90 | Professional | None | $70.79 | $660.69 | $1,174.90 |
SummaCare Setting Facility Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,445.44 | Facility | None | $1,230.27 | $1,288.25 | $1,445.44 |
SummaCare Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,318.26 | Professional | None | $912.01 | $1,000.00 | $1,318.26 |
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 $467.74 Median $891.25 Typical High $1,905.46 | Professional | None | $467.74 | $891.25 | $1,905.46 |
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 $512.86 Median $512.86 Typical High $1,778.28 | Professional | 52 · Reduced service | $512.86 | $512.86 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $724.44 | Professional | 53 · Discontinued | $208.93 | $208.93 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $2,691.53 | Professional | 54 · Surgery only | $776.25 | $776.25 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $537.03 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $354.81 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $2,511.89 |
Where Ohio sits
The same service costs 7.8 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· 49th of 51
$724
AK $4,365TX $562
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.