How much rates vary
Facilitymedian $617 · 10th to 90th $129 to $3,715Professionalmedian $288 · 10th to 90th $55 to $479
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 $812.83 Median $1,995.26 Typical High $10,964.78 | Facility | None | $812.83 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $891.25 | Professional | None | $229.09 | $302.00 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,311.31 | Facility | None | $371.54 | $831.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $436.52 | Professional | None | $208.93 | $263.03 | $436.52 |
Aultcare Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $389.05 | Facility | None | $125.89 | $162.18 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $1,479.11 | Facility | None | $131.83 | $245.47 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $562.34 | Professional | None | $302.00 | $380.19 | $562.34 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $1,479.11 | Facility | None | $131.83 | $234.42 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $562.34 | Professional | None | $302.00 | $380.19 | $562.34 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $223.87 Typical High $436.52 | Professional | None | $33.88 | $223.87 | $436.52 |
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 $316.23 Median $371.54 Typical High $436.52 | Professional | None | $316.23 | $371.54 | $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 $208.93 Median $316.23 Typical High $562.34 | Professional | None | $208.93 | $316.23 | $562.34 |
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 $151.36 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $263.03 | Professional | 54 · Surgery only | $229.09 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $213.80 | $229.09 | $245.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $389.05 Typical High $645.65 | Professional | 50 · Both sides | $316.23 | $389.05 | $645.65 |
Where Ohio sits
The same service costs 5.9 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· 48th of 51
$295
AK $1,288UT $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.