How much rates vary
Facilitymedian $1,905 · 10th to 90th $794 to $10,233Professionalmedian $427 · 10th to 90th $79 to $776
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 $851.14 Median $5,011.87 Typical High $12,589.25 | Facility | None | $851.14 | $5,011.87 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,995.26 | Professional | None | $562.34 | $562.34 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $7,762.47 | Facility | None | $724.44 | $1,819.70 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $758.58 | Professional | None | $331.13 | $416.87 | $758.58 |
Aultcare Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,047.13 | Professional | None | $630.96 | $630.96 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $1,513.56 Typical High $1,995.26 | Facility | None | $724.44 | $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 $575.44 Median $724.44 Typical High $954.99 | Professional | None | $575.44 | $724.44 | $954.99 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,122.02 | Professional | None | $575.44 | $724.44 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $316.23 Typical High $645.65 | Professional | None | $67.61 | $316.23 | $645.65 |
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 $524.81 Median $549.54 Typical High $870.96 | Professional | None | $524.81 | $549.54 | $870.96 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $10,471.29 | Facility | None | $912.01 | $3,388.44 | $10,471.29 |
United Setting Professional Modifier None Typical Low $354.81 Median $575.44 Typical High $1,023.29 | Professional | None | $354.81 | $575.44 | $1,023.29 |
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 $281.84 Median $281.84 Typical High $794.33 | Professional | 52 · Reduced service | $281.84 | $281.84 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $323.59 | Professional | 53 · Discontinued | $112.20 | $112.20 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $1,202.26 | Professional | 54 · Surgery only | $416.87 | $416.87 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $239.88 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $158.49 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $1,122.02 |
Where Ohio sits
The same service costs 4.7 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $8,820MT $1,888
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.