How much rates vary
Facilitymedian $562 · 10th to 90th $129 to $3,548Professionalmedian $282 · 10th to 90th $54 to $457
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 $467.74 Median $1,023.29 Typical High $10,715.19 | Facility | None | $467.74 | $1,023.29 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $741.31 | Professional | None | $234.42 | $309.03 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $398.11 Typical High $467.74 | Professional | None | $186.21 | $398.11 | $467.74 |
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 $194.98 Median $245.47 Typical High $416.87 | Professional | None | $194.98 | $245.47 | $416.87 |
Aultcare Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $562.34 | Professional | None | $331.13 | $389.05 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $363.08 | Facility | None | $125.89 | $162.18 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $467.74 | Professional | None | $302.00 | $380.19 | $467.74 |
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 $281.84 Median $354.81 Typical High $524.81 | Professional | None | $281.84 | $354.81 | $524.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $1,348.96 | Facility | None | $131.83 | $245.47 | $1,348.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $524.81 | Professional | None | $281.84 | $380.19 | $524.81 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $218.78 Typical High $416.87 | Professional | None | $33.88 | $218.78 | $416.87 |
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 $288.40 Median $316.23 Typical High $363.08 | Professional | None | $288.40 | $316.23 | $363.08 |
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 $194.98 Median $295.12 Typical High $524.81 | Professional | None | $194.98 | $295.12 | $524.81 |
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 $141.25 Median $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $141.25 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $56.23 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 54 · Surgery only | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $42.66 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $213.80 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $199.53 | $213.80 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $363.08 Typical High $616.60 | Professional | 50 · Both sides | $295.12 | $363.08 | $616.60 |
Where Ohio sits
The same service costs 5.5 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
$282
AK $1,202UT $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.