How much rates vary
Facilitymedian $933 · 10th to 90th $200 to $4,677Professionalmedian $389 · 10th to 90th $51 to $617
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 $562.34 Median $3,235.94 Typical High $12,589.25 | Facility | None | $562.34 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $1,318.26 | Professional | None | $389.05 | $426.58 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,148.15 Typical High $4,466.84 | Facility | None | $457.09 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $549.54 | Professional | None | $269.15 | $331.13 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,047.13 | Facility | None | $501.19 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $933.25 Typical High $1,584.89 | Facility | None | $363.08 | $933.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $724.44 | Professional | None | $389.05 | $489.78 | $724.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $933.25 Typical High $1,584.89 | Facility | None | $389.05 | $933.25 | $1,584.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $707.95 | Professional | None | $389.05 | $489.78 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $331.13 Typical High $562.34 | Professional | None | $33.88 | $331.13 | $562.34 |
SummaCare Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Facility | None | $446.68 | $467.74 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $562.34 | Professional | None | $389.05 | $478.63 | $562.34 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,951.21 | Facility | None | $97.72 | $275.42 | $2,951.21 |
United Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $707.95 | Professional | None | $269.15 | $407.38 | $707.95 |
7 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 $194.98 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $194.98 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $501.19 Typical High $831.76 | Professional | 50 · Both sides | $398.11 | $501.19 | $831.76 |
Where Ohio sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$389
AK $1,738UT $324
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.