How much rates vary
Facilitymedian $933 · 10th to 90th $195 to $4,677Professionalmedian $550 · 10th to 90th $89 to $912
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 $1,380.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $2,630.27 | Professional | None | $676.08 | $676.08 | $2,630.27 |
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 $489.78 Median $616.60 Typical High $1,000.00 | Professional | None | $489.78 | $616.60 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $912.01 Typical High $1,513.56 | Professional | 50 · Both sides | $741.31 | $912.01 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $851.14 Typical High $1,047.13 | Facility | None | $812.83 | $851.14 | $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 $691.83 Median $870.96 Typical High $1,258.93 | Professional | None | $691.83 | $870.96 | $1,258.93 |
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 $691.83 Median $870.96 Typical High $1,230.27 | Professional | None | $691.83 | $870.96 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $446.68 Typical High $794.33 | Professional | None | $70.79 | $446.68 | $794.33 |
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 $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
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 $426.58 Median $707.95 Typical High $1,230.27 | Professional | None | $426.58 | $707.95 | $1,230.27 |
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 $338.84 Median $338.84 Typical High $1,148.15 | Professional | 52 · Reduced service | $338.84 | $338.84 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $457.09 | Professional | 53 · Discontinued | $134.90 | $134.90 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $1,698.24 | Professional | 54 · Surgery only | $501.19 | $501.19 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $338.84 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $229.09 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $1,584.89 |
Where Ohio sits
The same service costs 8.5 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
$562
AK $2,818TX $331
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.