How much rates vary
Facilitymedian $525 · 10th to 90th $98 to $3,311Professionalmedian $269 · 10th to 90th $54 to $437
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 $478.63 Median $812.83 Typical High $12,022.64 | Facility | None | $478.63 | $812.83 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $776.25 | Professional | None | $281.84 | $295.12 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $407.38 | Professional | None | $281.84 | $407.38 | $407.38 |
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 $162.18 Median $204.17 Typical High $389.05 | Professional | None | $162.18 | $204.17 | $389.05 |
Aultcare Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $245.47 | Facility | None | $58.88 | $144.54 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $501.19 | Professional | None | $275.42 | $346.74 | $501.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $323.59 | Facility | None | $58.88 | $144.54 | $323.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $501.19 | Professional | None | $275.42 | $346.74 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $223.87 Typical High $398.11 | Professional | None | $33.88 | $223.87 | $398.11 |
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 $234.42 Median $295.12 Typical High $436.52 | Professional | None | $234.42 | $295.12 | $436.52 |
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 $173.78 Median $269.15 Typical High $501.19 | Professional | None | $173.78 | $269.15 | $501.19 |
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 $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | 54 · Surgery only | $213.80 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $223.87 |
Where Ohio sits
The same service costs 5.6 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
$269
AK $1,230TX $219
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.